Renal and ureteral duplication
Introduction
Introduction to renal and ureteral duplication Renal and ureteral duplication is a common congenital malformation of the urinary system. It can repeat the kidney and ureteral malformation. It can be unilateral or bilateral. It is more unilateral than bilateral, and the right side is four times more than the left side. There are many males, and their incidence rates vary from one to the other. Campbell's statistics showed that 342 cases of ureteral duplication were found in 51,880 autopsy, 1:160; however, 138 cases were found in 4,774 X-ray examinations by Nordamrk; 1:35; Thompson and Amar statistics urinary For patients, 6% of patients with urinary tract angiography had repeated ureteral malformations. basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: kidney stones
Cause
Causes of renal and ureteral duplication
In the sixth week of human embryo, the end of the middle kidney tube (Walfin tube) enters the cloaca, and a small blind tube protrudes from the dorsal side, called the ureter bud. The ureter bud grows rapidly, and the top is the original kidney. Surrounded by tissues, such as broad beans, ureteral buds develop into renal pelvis, branches form renal pelvis, and then branch into small sputum, collecting tubes, such as branches too early, forming repeated ureteral malformations, the height and number of branches, can determine the formation of complete Or incomplete, double or multiple ureteral malformations, repeated ureters often accompanied by repeated kidneys, repeated renal majority combined into one, with a common capsule, the surface has a shallow groove, but the renal pelvis and vasculature are separated, repeat the kidney completely separated, Very rare.
Prevention
Kidney and ureteral duplication prevention
Renal and ureteral duplication is a common congenital malformation of the urinary system and cannot be prevented.
Complication
Renal and ureteral duplication complications Complications kidney stones
Pyelonephritis; kidney stones; tuberculosis; tumor;
Symptom
Renal and ureteral duplication symptoms common symptoms enuresis, urinary urgency, urinary frequency
Renal pyelography is particularly important. When intubation is performed for retrograde angiography, retrograde pyelography should be used as much as possible to make it clear. If the intubation is restricted and the test is not satisfactory, it should be converted to intravenous pyelography, such as due to renal function. If the kidney can't be developed, and it is very suspicious, you can use double contrast agent and delay the filming method to make it clear and clear.
Examine
Examination of renal and ureteral duplication
Urinary examination and intravenous pyelography:
Laboratory test
Urine routine examination can be seen red blood cells, white blood cells or crystals. Urine pH is often acidic in patients with oxalate and urate stones; phosphate stones are often alkaline. When there were more infections, more pus cells appeared in the urine. When the infection was heavier, blood counts and neutrophils increased.
2. Radiography
X-ray examination is an important method for diagnosing kidney and ureteral stones. More than 95% of urinary calculi can be developed on X-ray films. Combined with excretory or retrograde pyelolithoscopy, the location of the stone, the presence or absence of obstruction and obstruction, the contralateral renal function, the calcification shadow from the urinary tract, the exclusion of other lesions of the upper urinary tract, and the treatment of the upper urinary tract are determined. The program and the comparison of the location, size and number of stones after treatment have important value.
3. Other inspections
B-ultrasound can detect dense spots or light clusters in the stone site, and the liquid level can be detected when the hydronephrosis is combined. Isotopic kidney examination showed an obstructive pattern of the urinary tract on the affected side.
Diagnosis
Diagnosis and differential diagnosis of renal and ureteral duplication
Renal pyelography is particularly important. When intubation is performed for retrograde angiography, retrograde pyelography should be used as much as possible to make it clear. If the intubation is restricted and the test is not satisfactory, it should be converted to intravenous pyelography, such as due to renal function. If the kidney can't be developed, and it is very suspicious, you can use double contrast agent and delay the filming method to make it clear and clear.
