calyceal stones
Introduction
Introduction a solid mass formed in the renal pelvis. Stones are mainly found in the gallbladder and bladder, renal pelvis, and can also be found in the lumen of the pancreatic duct, salivary ducts, etc., can cause luminal obstruction, affect the discharge of fluids in the affected organs, causing pain, bleeding or infection. Stones consist of inorganic salts or organic matter. There is a normal core in the stone, which consists of exfoliated epithelial cells, bacterial agglomerates, parasite eggs or worms, fecal blocks or foreign bodies. The inorganic salts or organic matter are deposited on the core layer. Due to the different organs involved, the composition, shape, texture, and influence on the body of the mechanism of stone formation are different. Small stones in the renal pelvis and renal pelvis can move with the body position. The shape of the larger stone is consistent with the shape of the cavity, which can be expressed as a typical staghorn or coral. Sometimes stones can fill the entire renal pelvis and renal pelvis and resemble the performance of pyelography. Lateral view, most of the kidney stones overlap with the spine.
Cause
Cause
Both normal intra-urine crystal saturation and crystal polymerization inhibitor activity are in equilibrium. Once the balance is broken due to some factors, whether the former is too saturated or the latter activity is reduced, it can cause intra-urine Crystallization causes urolith formation. The following factors have a significant effect on the cause of urinary stones.
1. Systemic factors:
1 metabolic disorders; 2 diet and nutrition; 3 long-term bed rest; 4 living environment; 5 mental, gender, genetic factors.
2. Local factors of the urinary system:
1 urinary tract infection; 2 urinary tract chronic hard resistance; 3 foreign bodies.
Examine
an examination
Related inspection
Renal ultrasonography renal angiography intravenous pyelography (IVP)
1, according to medical history, physical examination and necessary X-ray, laboratory tests, etc., it is not difficult to make a diagnosis of kidney stones, but should also further understand the size, number, shape and location of stones, with or without obstruction, infection, renal function Decreased, as well as possible primary cause and estimated composition of the stone.
2, in the history of the disease with hemorrhage after lumbar pain, or hematuria after exercise, should consider the possibility of kidney stones. 80% of kidney stones are microscopic hematuria, and a few are macroscopic or painless hematuria. There are also symptoms of urinary tract infections, such as pus cells and bacterial urine in the urine. The discovery of crystals in the urine or the history of row stones in the urine is an important clue for the diagnosis of urinary calculi. B-mode ultrasound is more likely to detect kidney stones and hydronephrosis.
3, urinary X-ray film is an important method to diagnose kidney stones, you can also see the shape of the kidney, the size, shape and location of the stone. About 90% of urinary calculi contain calcium and are shown on plain films. Therefore, urinary tract plain film is an indispensable test for diagnosing kidney stones. X-ray urinary tract plain film shows the clarity of the stone, mainly depends on the composition and thickness of the stone, and is also affected by the fat and thinness of the patient, the amount of gas accumulated in the intestine, and the advantages and disadvantages of the filming technique. The more calcium is contained in the stone, the more clearly the film is developed. When the calcium content is low or the stones are small, the development is unclear, and even the blur is not visible. However, if the senna leaves are 6 to 9 g or enema before the filming, it may be detected. Pure uric acid stones or cystine stones are not shown on the flat sheet because they do not contain calcium. They are called negative stones, accounting for about 3 to 5% of all urinary stones.
4, further examination is to carry out intravenous urography, to understand the function of the kidneys, with or without water and the entire urinary tract, and provide a basis for the choice of treatment; can also find local causes of kidney stones, such as congenital ureteropelvic ureteral junction It is narrow, deformed by hoof-shaped kidney and polycystic kidney. Negative stones can be characterized as occupying changes in the renal pelvis. Patients with iodine allergy and negative stones are eligible for cystoscopy and retrograde pyelography, and if necessary, pyelography.
Diagnosis
Differential diagnosis
Upper abdominal pain caused by right kidney stones must be differentiated from biliary stones, ulcer disease, pancreatitis, etc., but these patients have no red or white blood cells. Although calcification of biliary calculi or abdominal lymph nodes can also be developed in plain films, the lateral plane is flat, the shadow of the kidney stones overlaps with the lumbar vertebrae or is located later in the vertebral body, and the calcification of the biliary calculi or intra-abdominal lymph nodes is located in front of the vertebral body. Increased blood uric acid levels in patients with uric acid stones. Urine PH is characterized by persistent strong acidity, and patients have gout.
