Medicine · 2026
Adolescent idiopathic ureteral stricture: A multimodal diagnostic and surgical approach in resolving hydronephrosis.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Liu Zhongwei, Huang Denghui, Yang Wenjiang
Аннотация
RATIONALE: Idiopathic ureteral strictures in adolescents are rare and poorly understood, posing diagnostic and therapeutic challenges due to their unclear etiology and lack of pediatric-specific management guidelines. Existing evidence predominantly derives from adult studies, leaving gaps in understanding pathophysiology, optimal interventions, and long-term outcomes in younger populations.
PATIENT CONCERNS: A 16-year-old male presented with asymptomatic left hydronephrosis detected during routine physical examination. Laboratory tests revealed elevated white blood cell count (12 × 10⁹/L) and 1+ leukocytes in urinalysis, prompting further investigation.
DIAGNOSES: Imaging modalities, including urinary tract ultrasound and computed tomography urography, identified severe left hydronephrosis and pelvic ureteral wall thickening. Ureteroscopy and retrograde pyelography localized a stricture at the fifth lumbar vertebra level. Histopathological analysis confirmed chronic inflammation, vascular hyperplasia, and polypoid proliferation at the stricture site.
INTERVENTIONS: The patient underwent laparoscopic segmental ureteral resection with primary anastomosis, concomitant laparoscopic ureteral stent placement, and postoperative anti-inflammatory therapy.
OUTCOMES: Follow-up computed tomography urography at 3 months demonstrated complete resolution of hydronephrosis and successful stent removal. The patient remained asymptomatic with normalized laboratory parameters.
LESSONS: This case highlights chronic inflammation as a potential driver of idiopathic ureteral strictures in adolescents, contrasting with fibrosis-dominated adult cases. It validates multimodal imaging and surgical resection as effective diagnostic and therapeutic strategies while emphasizing anatomical vulnerability at the fifth lumbar vertebra. The findings advocate for pediatric-focused research to explore inflammatory biomarkers, genetic predispositions, and minimally invasive alternatives.
PATIENT CONCERNS: A 16-year-old male presented with asymptomatic left hydronephrosis detected during routine physical examination. Laboratory tests revealed elevated white blood cell count (12 × 10⁹/L) and 1+ leukocytes in urinalysis, prompting further investigation.
DIAGNOSES: Imaging modalities, including urinary tract ultrasound and computed tomography urography, identified severe left hydronephrosis and pelvic ureteral wall thickening. Ureteroscopy and retrograde pyelography localized a stricture at the fifth lumbar vertebra level. Histopathological analysis confirmed chronic inflammation, vascular hyperplasia, and polypoid proliferation at the stricture site.
INTERVENTIONS: The patient underwent laparoscopic segmental ureteral resection with primary anastomosis, concomitant laparoscopic ureteral stent placement, and postoperative anti-inflammatory therapy.
OUTCOMES: Follow-up computed tomography urography at 3 months demonstrated complete resolution of hydronephrosis and successful stent removal. The patient remained asymptomatic with normalized laboratory parameters.
LESSONS: This case highlights chronic inflammation as a potential driver of idiopathic ureteral strictures in adolescents, contrasting with fibrosis-dominated adult cases. It validates multimodal imaging and surgical resection as effective diagnostic and therapeutic strategies while emphasizing anatomical vulnerability at the fifth lumbar vertebra. The findings advocate for pediatric-focused research to explore inflammatory biomarkers, genetic predispositions, and minimally invasive alternatives.