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患者男性,50岁。因反复发作左腰背部酸痛伴间歇肉眼血尿3年于1985年11月23日入院。发病时无尿频、尿急、尿痛及发热等症。体检:一般情况尚可.左上腹略饱满,无移动性浊音,左肾区叩痛及轻压痛.立位时可触及左肾下极,表面不平,压之胀痛感.尿常规蛋白(?),RBC 满视野.WBC2/HP.尿培养无细菌生长。B 超检查提示左肾积水.KUB、JVP 示肾盂扩张积液,左肾(?)盏有3玫直径约0.cm圆形结石。右侧尿路显影正常。膀胱镜检见膀胱内粘膜水导充血明显。逆行插管因左输尿管口粘膜水肿未能插入。行左肾探查。术中见左肾明显增大积液,体积约20×15×13cm.肾皮质变薄,肾盂输尿管连接部扭曲梗阻,在梗阻段输尿管处可触及腔内有一(?)生物,质软,光滑,并可上下活动.远端输尿管正常.切开扩张肾盂,见左肾盂输尿管连接部有一膈膜样皱折突入管腔,呈叶瓣状,表面粘膜复盖,瓣膜中央可见针尖样小孔,瓣膜上下粘膜正常,
Male patient, 50 years old. Due to recurrent left lower back pain with intermittent gross hematuria 3 years in November 23, 1985 admission. Occurrence of urinary frequency, urgency, dysuria and fever embolism. Physical examination: the general situation is acceptable .Light upper left abdomen slightly full, no movement of dullness, left kidney area percussion pain and mild tenderness .Left position can reach the lower left kidney, uneven surface, pressure pain. ), RBC full field of vision .WBC2 / HP. Urinary culture without bacterial growth. B-ultrasound showed left hydronephrosis, KUB, JVP showed pyelic splenic effusion, left kidney (3) diameter of about 3 rose 0. .0 Round stone. Right urinary tract normal development. Cystoscopy see bladder mucosal water congestion significantly. Retrograde intubation due to left ureteral mucosal edema failed to insert. Row of kidney exploration. Surgery, see the left kidney was significantly increased fluid volume of about 20 × 15 × 13cm. Renal cortical thinning, ureteropelvic junction distorted obstruction in the obstruction ureter Department can touch the cavity has a (?) Creature, soft, smooth , And up and down activities .Dialation of the distal ureter .Expansion dilation of the renal pelvis, see the left ureteropelvic junction has a diaphragm-like folds broke into the lumen was lobular, surface mucosal coverage, the tip of the valve can be seen in the central needle-like holes, Valve up and down the normal mucosa,