abnormal renal rotation
Introduction
Introduction to renal rotation abnormalities The normal kidney is located in the renal fossa, the renal pelvis is facing the side wall, and the renal pelvis is open to the medial side. Otherwise, it is called rotational abnormality. Firstly, similar results due to external force factors such as retroperitoneal tumor pushing should be excluded. basic knowledge The proportion of illness: 0.0001% - 0.0005% Susceptible people: no special people Mode of infection: non-infectious Complications: hydronephrosis
Cause
Abnormal cause of renal rotation
(1) Causes of the disease
It is generally believed that abnormal rotation of the kidney occurs during renal migration. At the 6th week, the kidney moves out of the pelvis, and the kidney begins to rotate until about 90° at the 9th week. Some people think that abnormal renal rotation is due to the asymmetry of the ureteral tree branch. On the ventral side, the dorsal side of the two sides, Weyranch et al. also believe that the rotation of the kidney differentiates more rapidly toward the ventral side than to the tissue on the dorsal side, causing a rotation error in the process.
(two) pathogenesis
Weymuch divides the rotation abnormality into 4 types according to the position of the renal pelvis:
1. Ventral position: Since the kidney does not rotate when it rises, the renal pelvis still points to the ventral side, and the renal pelvis points to the dorsal side. This is the most common type, and very rare is 360° excessive rotation.
2. Abdominal midline position: caused by incomplete rotation, the renal pelvis points to the front and the anterior kidney, and the renal pelvis points to the outside.
3. Dorsal position: The kidney rotates 180°, and the renal pelvis faces the back side. This type is the least common.
4. Lateral position: The kidney rotates more than 180°, but is less than 360°, or reverses 180°, the renal pelvis points to the outside, and the renal pelvis points to the midline.
Prevention
Abnormal kidney rotation prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Abnormal renal rotation complications Complications hydronephrosis
Usually one side of the rotation is abnormal and the other side of the kidney is abnormal, such as ectopic fusion, hoof and kidney.
Symptom
Abnormal symptoms of renal rotation Common symptoms Hematuria
Abnormal kidney rotation itself does not produce specific symptoms, but excessive fibrous tissue surrounding the renal pelvis, ureteropelvic junction and upper ureter, and additional vascular compression can cause obstruction, and symptoms of hydronephrosis or intermittent renal colic, Hematuria, infection and stones can also occur, often accompanied by ectopic kidneys, which can cause renal vascular or ureteral compression and corresponding clinical manifestations.
Examine
Examination of abnormal renal rotation
Urine routine examination and microscopic hematuria, violent activities can induce or aggravate.
1. X-ray inspection:
Excretory urography showed abnormality of the renal pelvis and renal pelvis, flattening and elongation of the renal pelvis, and the angle between the long axis of the kidney and the midline became smaller (normally about 16°) or parallel to the midline. The upper 1/3 of the ureter was displaced outward, sometimes the renal pelvis was visible. A narrow, distorted or ectopic vascular compression sign at the ureteral junction.
2. CT examination:
It can clearly show the abnormality of the renal pelvis, and according to the direction of the renal pelvis, it can be clear whether the abnormal rotation of the kidney is the anterior, anterior, posterior or lateral position.
Diagnosis
Diagnostic diagnosis of renal rotation abnormality
diagnosis
Azimuth abnormalities of the renal pelvis and renal pelvis can be found by renal ultrasound and secretory urography.
Differential diagnosis
1. Retroperitoneal tumor:
Can cause abnormal rotation of the kidney, but often can reach the edge of the unclear mass, the mass will progressively increase, the patient's general condition is poor, with the progress of the disease can appear compression symptoms, B-ultrasound, CT examination can find a retroperitoneal mass.
2. Kidney occupying lesions:
Can cause abnormal rotation of the kidney, but often there are gross hematuria, low back pain and mass, urography can cause pressure or destruction of renal pelvis and renal pelvis, B-ultrasound, CT showed tumor imaging.
3. Horseshoe Kidney:
Abnormal rotation of both kidneys may be mistaken for horseshoe kidney in X-ray examination, but the horseshoe kidney can be found on the urinary tract plain film and urography, and the isthmus can be found. B-ultrasound, CT, and radionuclide kidney scans are all shown. The isthmus is connected.
