Nephroptosis

Nephroptosis

: heightened kidney's mobility.

Clinical manifestation

Nephroptosis mainly young women. Hospital to a group of 100 cases Nephroptosis case analysis, women accounted for 71%. Ages 20 and 40 years old (83%), and young and middle-aged women heavier physical load, the value of child-bearing age, After the birth abdominal muscle relaxant, and post-abdominal pressure is suddenly reduced on. In the course of 6 months to 3 years, 60%, mostly because of lumbar acid, chronic urinary tract infection, recurrent hematuria, and other symptoms can lay hands on medical treatment and kidney disease diagnosis drawn.

Nephroptosis symptoms are three major categories :

(1) urinary symptoms accounted for 92% of lumbar pain. More than 50% of patients with chronic urinary tract infection symptoms, most of urinary frequency, urgent urination and other symptoms of bladder stimulation. One-third of the cases has been associated with low heat or a history of recurrent fever. Occasionally, such as lower extremity edema performance.

(2) gastrointestinal symptoms: abdominal distention, nausea, vomiting, etc.

(3) neurotic symptoms such patients often more tense, accompanied by insomnia, dizziness weak, the loss of memory, The incidence of about one-fifth or so. These symptoms have with nephroptosis not necessarily proportional to the degree. Although sometimes re-degree drop, but can cause obvious symptoms. Experience : 46% of the cases of kidney pain District Tap. Right kidneys could lay hands on the 64% left palpable for 22%. By anatomical location on the lower right kidney, renal fossa junior, once the impact of the liver, it is also the right Nephroptosis more than the left.

Differential diagnosis

(1) history and physical examination

:complained of urinary system, gastrointestinal tract and the neurotic symptoms, and medical examination found that basically can make an impression diagnosis.

(2) X-ray inspection must intravenous pyelography (vertical and horizontal position)performed in the last standing unit to understand the extent of its activities. But in a perturbation standing films must stand up immediately, otherwise contrast agent after the row do not show kidney, sometimes kidney ptosis yet to peacetime locations.

According to the imaging activities, we are divided into three categories :

Mild : kidney in an activity within the vertebral body;

Moderate : Renal activity in within two vertebrae;

Severe : kidney activity in the two vertebrae above or associated with hydronephrosis, kinking. Another part of a case although IVP unable to see the ground, but from the symptoms, physical examination and ultrasound examination can make Nephroptosis diagnosis.

(3) Ultrasonography in the first foot-high half-hour later ultrasound kidney fixed location and activities of the kidney's position kidney can be drawn between the activity.

(4) Test bow lying low respiration first three full days of high-lying (in a brick beds raise the height diameter), at the bedside, and were measured hourly or urine excretion rate urinating blood cells, and to observe any symptoms ease. If sleep after urine blood cells significantly reduced or even disappear, symptoms, and support for Nephroptosis diagnosis, can be alleviated without exception Nephroptosis factors.

(5) water injection of clear whether patients with low back pain from the kidney, via cystoscopy ureteral catheter within the pelvis after injection until waist feel pain. If the nature and location of pain with peacetime attack were similar to the positive support Nephroptosis diagnosis; If not similar to those negative, Nephroptosis not cause symptoms.

Diagnostic criteria : patients can be symptoms, signs, X-ray inspection of the combined degree Nephroptosis a judgment.

Mild : a typical lumbar pain symptoms, not palpable or only under very touched kidney. Some patients with renal area knock pain, IVP renal activity of a vertebral body, Renal ultrasound inspection activity to 3cm, sometimes hematuria (mostly microscopic examination), or urinary tract infection complications.

Moderate : a clear lumbar pain symptoms associated with gastrointestinal and neurological symptoms of functional areas. Kidney can be palpable. 22636 kidney activity in two vertebrae within three ultrasonic inspection ~6cm between the activity. Most associated with hematuria or urinary tract infection complications.

Severe : a clear symptoms and signs outside. 22636 see renal activity over two vertebrae above, or has not more than two vertebrae, but there are obvious distortions ureter, hydronephrosis, renal calculi or merger of functions between the decline. Renal ultrasound inspection activity in the 6 cm above.

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