特发性腹膜后纤维化误诊为输尿管癌1 例报告并文献复习

目的:分析并掌握腹膜后纤维化的诊疗特点,避免对该病的误诊误治。方法:回顾性分析1例腹膜后纤维化患者分别因两侧肾积水先后两次住院并最终确诊的诊疗过程中的临床资料,包括临床表现、影像特点、病理结果、治疗方法及预后等,并结合相关文献进行复习。结果:患者因右肾积水首次入院诊断为右输尿管癌而行右侧肾输尿管切除术,后患者因左肾积水来我院住院诊断为腹膜后纤维化,行腹腔镜输尿管松解+腹腔内置术,术后长期随访疗效满意。结论:腹膜后纤维化作为一种少见病,缺乏对其认识极易导致误诊误治,掌握该疾病的临床特点及选择适宜的治疗方案,对本病的诊疗具有重要意义。

A Case of Idiopathic Retroperitoneal Fibrosis Misdiagnosis as Ureteral Carcinoma and Literature Review

Objective: To analyze and master the clinical characters of an idiopathic retroperitoneal fibrosis(IRPF) case to avoid the misdiagnosis and mistreatment.Methods: Analyzed the clinical data of an IRPF case who had been hospitalized twice because of unilateral hydronephrosis occurred on both sides successively,including clinical manifestations,radiographic evaluations,pathological results,treatment protocols and prognosis.Reviewed the literatures related to RPF in recent years.Results: The patient received the nephroureterectomy on right because she was misdiagnosed as ureteral carcinoma at the first hospitalization.The laparoscopic ureterolysis on left was performed on her because of the preoperative diagnosis of IRPF which was confirmed by the pathological result.The 3 years’ follow up revealed the satisfied therapeutic effects.Conclusions: As a rare disease,the incidence of misdiagnosis on IRPF patients was relatively high,especially when the physician’s knowledge of this disease was insufficient.It is meaningful to master the essentials of the diagnosis of this disease and choose the optimal treatment according to the individual conditions.