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患者,男,17岁。因血尿1周伴右腰痛排尿难5天来诊,外院B超诊断“膀胱占位”,因治疗无效到我院急诊,腹部B超检查:左肾111×48mm实质厚19mm,肾盂分离10mm,肾内未见强光团。右肾脏114×57mm,实质厚16mm,实质回声弥漫性增强,肾内结构紊乱,显示不清,未见强光团及肾盂分离。膀胱充盈不佳,于膀胱三角区见一大小约85×96mm实质性稍强回声肿块向膀胱内突出,并占据大部分膀胱,肿块边尚清,内回声不均匀,与膀胱壁关系显示不清,肿块不随体位改变而移动。提示:1.右肾弥漫性病变;2.膀胱占位(膀胱肿瘤?)。 入院后,病人予以抽血,吸出血块800ml,后膀胱镜检查示:术中清出陈旧性凝血块150ml。同时可见右输尿管口卡有一血块不能钳出,膀胱内壁充血,可见散在血块,经冲洗,冲洗液清,未见出血,膀胱内未见明显肿块回声。尿涂片未见癌细胞。右肾切除,术后病理诊断:右肾特发性肾出血型(肾紫
Patient, male, 17 years old. Due to hematuria 1 week with right lower back pain urination difficult to diagnose 5 days, the B-ultrasound diagnosis of “bladder occupancy” due to ineffective treatment to our emergency room, abdominal B-ultrasound: the left kidney 111 × 48mm thick, 19mm, renal pelvis separation 10mm, No glaucoma in the kidneys. The right kidney 114 × 57mm, the actual thickness of 16mm, diffuse substantive echo enhancement, renal structure disorders, showed unclear, no glaucoma and renal pelvis separation. Bad filling of the bladder, see a size of about 85 × 96mm in the bladder triangle slightly stronger echo mass protruding to the bladder, and occupy most of the bladder, the tumor side is still clear, uneven echo, and the bladder wall showed unclear , Mass does not change with the position and move. Tip: 1. Right kidney diffuse lesions; 2. Bladder occupancy (bladder tumor?). After admission, the patient was drawn blood, aspirated blood clots 800ml, after cystoscopy showed: out of the clot during the operation clot 150ml. At the same time we can see the right ureter orifice card can not clamp a blood clot, the bladder wall congestion, visible scattered blood clots, after washing, rinse liquid, no bleeding, no significant cystic echo in the bladder. Urine smear no cancer cells. Right nephrectomy, postoperative pathological diagnosis: Right kidney idiopathic renal hemorrhage (kidney purple