RESUMO
RESUMEN La frecuencia de la enfermedad herniaria es una de las más altas dentro de los cuadros quirúrgicos. Sin embargo, su asociación al megauréter en el saco herniario o contenido es extremadamente rara y existen pocos reportes en la literatura internacional. El diagnóstico es incidental, ya sea por hallazgo transoperatorio o por estudios contrastados de imagen. Se presenta el caso clínico de un paciente con antecedente de hernia inguinal que fue sometido a una herniorrafia hace veinte años y que se presenta a un servicio de urgencias con un aparente defecto herniario. Además, padece diabetes mellitus que está mal controlada. Durante la estancia hospitalaria se confirma la reaparición de la hernia con un saco que contiene megauréter y adherencias visceroparietales con ciego en posición subhepática.
ABSTRACT Herniation is one of the most frequent surgical conditions. However, the presence of a megaureter in the hernia sac or content is extremely rare. Little has been reported on this topic in the world literature, and its diagnosis has been incidentally reached either as an intraoperative finding or during different contrast imaging studies. This is the clinical case of a patient with a history of inguinal hernia who underwent a herniorrhaphy 20 years ago and presented to the emergency department with a diagnostic impression of a relapsed hernial defect. He also had poorly-controlled diabetes mellitus. During his hospital stay, a diagnosis of relapsed hernia sac containing a megaureter was confirmed, and visceral-parietal adhesions and a subhepatic cecum were found.
RESUMO
Ureteral valves are a rare malformation, with an incidence of 1 in 5000-8000 live births. Urological malformations are associated with 50% of cases according to the current literature. We report 4 cases treated in our hospital from 2004 to 2012. Three of the patients had renal dysgenesis, one case associated with complete urethral duplication, and another case associated with a ureteral atresia.
Assuntos
Ureter/anormalidades , Ureter/cirurgia , Feminino , Humanos , Lactente , MasculinoRESUMO
Se presenta un caso clínico y los hallazgos imagenológicos de una pioureterohidronefrosis en una paciente de 4 años de edad, sin antecedentes patológicos, con historia de 5 días de evolución con dolor abdominal, fiebre de 38,2ºC, dolor en hipocondrio y flanco izquierdo con ocupación del fondo de saco lateral izquierdo al tacto rectal.
A case of a 4 year old girl with no pathologic background, with pyoureterohydronephrosis is presented. The history was 5 days of abdominal pain and fever (38,2 Cº), and an occupation of the left recess in the rectal digital examination.Imagenologic studies demonstrate pyoureterohydronephrosis.
Assuntos
Humanos , Feminino , Pré-Escolar , Doenças Uretrais/complicações , Hidronefrose/diagnóstico , Hidronefrose , Doenças Uretrais/cirurgia , Nefrostomia PercutâneaRESUMO
Se presenta el caso de una enferma que acude al Cuerpo de Guardia del Hospital Dr Ernesto Guevara de la Serna de Las Tunas por dolor lumboabdominal izquierdo, se medica para alivio del dolor, se indica ecografía renal de urgencia, que informa la presencia de Hidronefrosis del riñón izquierdo- y un posible doble sistema excretor derecho. Se ingresa a la paciente indicándosele los estudios de sangre indispensables de sala, así como un urograma excretor, se observa un doble sistema excretor derecho y sospecha de un doble sistema excretor izquierdo con Hidronefrosis, se realiza cistoscopia comprobándose la presencia de un trígono con dos orificios ureterales a cada lado. Se opera la paciente encontrándose un doble sistema excretor con una compresión vascular del sistema inferior del riñón izquierdo. Este caso nos parece interesante por el hecho de que tiene un doble sistema excretor completo bilateral con dificultad en el drenaje del sistema inferior del riñón afecto, lo cual no se encuentra frecuentemente en la bibliografía(AU)
A case of a female patient who came in to the Emergency Room of the Hospital Dr Ernesto Guevara of the Serna complaining of pain in her left small back, the treatment to relief the pain was prescribed, urgency renal ecography was performed and it showed the presence of hydronephrosis of the left kidney and a possible double excretory system in the right side. The patient was admitted, the blood studies were prescribed, as well as an intravenous urogram, a double excretory system in the right side was observed and a double excretory system in the left side with hydronephrosis was suspected, the cistoscopy was carried out, it confirmed the presence of two ureterals orifices each side. The patient was operated and a double excretory system with a vascular compression of the inferior system of the left kidney was found. We believe this case is very interesting for the fact that the patient had a complete double excretory system bilateral with difficulty in the drainage of the inferior system of the affected kidney that is not common in the bibliography(AU)
