资源描述：
《kidney（nephroptosis）异位肾课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、ECTOPICKIDNEY(Nephroptosis)EctopickidneyusuallycausesnosymptomsunlesscomplicationssuchasureteralobstructionorinfectiondevelopCongenitaldisorders.Isalowkidneyonthepropersidewhichfailedtoascendnormally.(Overthepelvicbrim.Inthepelvis).Pronetoureteralobstructionandinfection,whichmayleadt
2、opainorfever.Palpableexaminationmayfindsuchakidney,leadingtoanerroneouspresumptivediagnosis,eg,cancerofthebowel,appendicealabscess.Excretoryorretrogradeurogramswillrevealthetrueposition.Hydronephrosis,ifpresent,willbeevident.Thereisnoredundancyoftheureter,asisthecausewithnephroptosis
3、oracquiredectopy(eg,displacementbylargesuprarenaltumor.Obstructionandinfectionmaycomplicateectopyandshouldbetreatedbyappropriatemeans.Anatomicvision:normalpelvicatthepositionofNo.1or2lumbarvertebrallevel,kidneymobilityrangeis1—4cmwithrespiration.Kidneydescendinglevelismuchthanthisran
4、geatthepositionofstandingwecallEctopicKidney.VARICOCELEVaricoceleiscommoninyoungmenandconsistsofdilatationofthepampiniformplexusabovethetestis.Theleftsideismostcommonlyaffected.Theseveinsdrainintotheinternalspermaticveinintheregionoftheinternalinguinalring.Thisveinpasseslateraltothev
5、asdeferensattheinternalinguinalringand,ontheleftside,drainintotherenalvein.Ontherightitemptiesintovenacava.Theleftinternalspermaticveinisparticularlyliabletohaveincompetentvalves.Thisfact,plusgravity,mayleadtopoordrainageofthepampiniformplexus,theveinsofwhichgraduallyundergodilatatio
6、nandelongation.Attimestheyarepainful.Suddendevelopmentinanoldmenissometimesasalatesignofrenaltumorwhichinvadedrenalvein,therebyoccludingthespermaticvein.Examinationuprightrevealsamassofdilated,tortuousveinlyingposteriortoandabovethetestis.ThedegreeofdilatationcanbeincreasedbytheValsa
7、lvamaneuver.Intherecumbentposition,venousdistentionabates.Testicularatrophyfromimpairedcirculationmaybepresent.Notreatmentisrequiredunlessthevaricoceleisthoughttocontributetoinfertilityorispainfulorsolargeastodisturbthepatient.Treatment:scrotalsupportwillrelievediscomfort;ligationofi
8、nternalsperm
