PDF(Pubmed)
Abstract：
Hydrocalyx is the obstruction of a renal calyx resulting from infundibulopelvic stenosis or diminution and can be congenital or acquired. A 37-year-old man with a history of preemptive kidney transplantation in 2007 and transplant rejection underwent another ABO-incompatible transplant. During follow-up four months after transplantation, a transplant biopsy was performed, which revealed acute thrombotic microangiopathy. Seven months after transplantation, the patient was admitted to the hospital because of elevated creatinine levels and dilatation of the upper calyx on ultrasound examination. Upper calyx hydrocalycosis and calyceal neck stenosis were diagnosed. Nephrostomy placement along with an antegrade double-J stent through the upper major calyceal neck was performed. Endoscopic dilatation of the narrowed neck of the upper major calyx 10 days after hydrocalyx decompression was performed without intraoperative or postoperative complications. During follow-up, the patient was asymptomatic, had steady creatinine levels, and showed no signs of obstruction on ultrasound. This case highlights that treatment with balloon dilation of the calyceal neck appears to be an effective solution that respects the renal parenchyma and function.
摘要：
水萼是由盆底漏斗狭窄或缩小引起的肾萼阻塞，可以是先天性的或后天性的。一名37岁的男子在2007年有抢先性肾移植和移植排斥的历史，接受了另一次ABO不相容的移植。在移植后四个月的随访中，进行了移植活检,显示急性血栓性微血管病。移植后7个月,由于肌酐水平升高和超声检查上花萼扩张，患者入院。诊断为上花萼积水和花萼颈狭窄。进行了肾造口术以及通过上主颈颈的顺行双J支架的放置。在水萼减压后10天进行上主萼狭窄颈部的内窥镜扩张，无术中或术后并发症。随访期间,病人无症状,肌酐水平稳定，超声检查没有阻塞的迹象.这种情况突出表明，用球囊扩张治疗肾盏颈似乎是一种有效的解决方案，可以尊重肾实质和功能。
