输尿管十二指肠瘘1例  

A case of ureteroduodenal fistula

作　　者：谭伍兵 吴志坚 邹义华[2] 邓旺龙[2] 龙稼[1] 陈晓峰 TAN Wubing;WU Zhijian;ZOU Yihua;DENG Wanglong;LONG Jia;CHEN Xiaofeng(Department of Urology,Chenzhou Hospital Affiliated to University of South China,Chenzhou,Hunan,423000,China;Department of Urology First People's Hospital of Chenzhou)

机构地区：[1]南华大学附属郴州医院泌尿外科,湖南郴州423000 [2]郴州市第一人民医院泌尿外科

出　　处：《临床泌尿外科杂志》2022年第7期564-568,共5页Journal of Clinical Urology

基　　金：郴州市第一人民医院院内科研课题资助项目(No:N2020-84)。

摘　　要：输尿管十二指肠瘘临床极其罕见,国内外仅报道24例,本文报道1例45岁男性患者,以右腰部间歇性胀痛伴反复发热3个月余入院。术前诊断为右肾无功能、右肾积水并感染、右输尿管扩张。行右肾切除术后第3天右侧腹膜后引流管引出墨绿色液体,通过口服造影剂后行CT平扫及重建确诊为输尿管十二指肠瘘。经保守治疗3周瘘管仍未闭合,进行瘘管切除与十二指肠瘘口修复术。追问患者病史,了解到患者幼时有多次小便排蛔虫病史,考虑蛔虫为可能病因。通过回顾性分析其临床资料和复习文献,探讨输尿管十二指肠瘘病因、临床表现、诊断与治疗。The ureteroduodenal fistula is extremely rare, and just 24 cases were reported at home and abroad. In our study, a 45-year-old man was admitted to the hospital for suffering from intermittent right loin pain with fever repeatedly for more than 3 months. The preoperative diagnosis was nonfunctioning right kidney, right hydronephrosis with infection and dilatation of the right ureter. On the third day after the operation of right nephrectomy, dark green fluid was collected from right retroperitoneal drainage tube. CT scan and reconstruction were performed after administration of oral contrast agents, by which the patient was diagnosed as ureteroduodenal fistula. After 3 weeks of conservative treatment, the fistula had still not closed. Further, the treatment was fistulectomy and duodenal repair. When a detailed inquiry was made about the patient’s medical history, it was learned that the patient had discharged ascaris from the urethra repeatedly in childhood. Therefore, ascaris is a possible etiologic factor. This paper investigates the etiology, clinical manifestation, diagnosis, treatment of ureteroduodenal fistula by retrospective analysis of this case and review of the literature.

关 键 词：输尿管十二指肠瘘 蛔虫 肾切除 瘘管切除 病例报告 

分 类 号：R693[医药卫生—泌尿科学]