双j型输尿管支架长期被动扩张:可能是治疗乳头状肾坏死所致复发性肾绞痛的有效方法。

Q4 Medicine Journal of Endourology Case Reports Pub Date : 2020-12-29 eCollection Date: 2020-01-01 DOI:10.1089/cren.2020.0141
Braulio O Manzo, Eduardo Tejeda, Ben H Chew, Pompeyo Alarcon, Edson Flores, J Ernesto Torres
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引用次数: 1

摘要

背景:复发性肾绞痛的不常见原因是继发于肾乳头坏死的粘膜组织通道。由于其发病率低,肾乳头状坏死(RPN)引起的复发性梗阻性尿病的正确处理尚不明确。病例介绍:我们提出了一个病例复发性肾绞痛与排泄粘膜组织在一个年轻的妇女的尿液与历史过量消耗非甾体抗炎药(NSAIDs)。由于肾绞痛反复发作,患者多次入院急诊。排出组织的肾盂造影和组织病理学检查支持RPN的诊断。患者接受双j型支架治疗12个月,完全停用非甾体抗炎药,并大量饮水。治疗后放射学和内窥镜检查结果满意。患者不再经历新的肾绞痛发作,因为被动输尿管扩张,尽管仍有尿中粘膜组织排出。结论:被动输尿管扩张联合双j支架可能是治疗持续性肾乳头坏死所致复发性肾绞痛的有效方法。
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Long-Term Passive Ureteral Dilatation with Double-J Stent: Possibly an Effective Treatment for Recurrent Renal Colic Caused by Papillary Renal Necrosis.

Background: An uncommon cause of recurrent renal colic is mucous tissue passage secondary to renal papillae necrosis. Because of its low prevalence, the correct management of recurrent obstructive uropathy produced by renal papillary necrosis (RPN) is not well defined. Case Presentation: We present a case of recurrent renal colic associated with the expulsion of mucous tissue in a young woman's urine with a history of excessive consumption of nonsteroidal anti-inflammatory drugs (NSAIDs). The patient required multiple admissions to the emergency department because of recurrent episodes of renal colic. A retrograde pyelogram and histopathologic study of the expulsed tissue supported the diagnosis of RPN. The patient was managed with Double-J stents for 12 months, complete withdrawal of NSAIDs, and large volume intake of water. A satisfactory outcome was seen radiologically and endoscopically after treatment. The patient stopped experiencing new renal colic episodes because of the passive ureteral dilatation despite still presenting the mucous tissue expulsion in the urine. Conclusions: Passive ureteral dilatation with Double-J stents could possibly be an effective treatment for patients with recurrent renal colic secondary to persistent renal papillae necrosis.

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