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Title 先天性水腎症 (congenital hydronephrosis)
Subtitle レビュー
Authors 米倉竹夫
Authors (kana)
Organization 現)奈良県総合医療センター小児外科, 前)近畿大学奈良病院小児外科
Journal 日本周産期・新生児医学会雑誌
Volume 58
Number 3
Page 420-443
Year/Month 2022 / 12
Article 報告
Publisher 日本周産期・新生児医学会
Abstract 「概要」 先天性水腎症(congenital hydronephrosis)は尿路の発生異常により腎盂・腎杯および尿管を含む尿路が先天性に拡張した病態である. 近年は胎児期や新生児期の超音波によるスクリーニング検査により無症候性の症例が多く発見されるようになった. 先天性水腎症は, 自然治癒するものから逆に腎障害が進行するものまでと, 幅広いスペクトラムを有しており, それぞれの疾患や病態に即した診療を行う必要がある. そこでまず総論として, 日本小児泌尿器科学会が発刊した小児先天性水腎症に対する診療手引の診療アルゴリズムに沿い, 胎児期から乳幼児期を中心に病態や症状, 画像診断, 診療の要点について述べる. さらに各論として, 先天性水腎症例の中で頻度が高く臨床的に問題となる腎盂尿管移行部通過障害, 膀胱尿管逆流, 尿管膀胱移行部通過障害, 尿管瘤, 異所性尿管, 後部尿道弁などの閉塞性下部尿路疾患について, 疾患の病態, 定義・分類・診断・内科的および外科的治療, 長期経過と管理について概説する.
Practice 臨床医学：外科系
Keywords 先天性水腎症, 診療手引き, 診療アルゴリズム, 腎盂尿管移行部通過障害, 膀胱尿管逆流, 尿管膀胱移行部通過障害, 尿管瘤, 後部尿道弁

English

Title Congenital Hydronephrosis
Subtitle
Authors Takeo Yonekura
Authors (kana)
Organization Department of Pediatric Surgery, Nara Prefecture General Medical Ceter (Current), Department of Pediatric Surgery, Nara Hospital, Kindai University (Previous)
Journal Journal of Japan Society of Perinatal and Neonatal Medicine
Volume 58
Number 3
Page 420-443
Year/Month 2022 / 12
Article Report
Publisher Japan Society of Perinatal and Neonatal Medicine
Abstract Congenital hydronephrosis is a congenital dilatation of the urinary tract, including the renal pelvis, renal calix, and ureter, due to developmental abnormalities of the urinary tract; in recent years, many asymptomatic cases have been detected by fetal and neonatal ultrasound screening tests. Congenital hydronephrosis has a broad spectrum, ranging from spontaneous resolution to conversely progressive renal damage, and it is necessary to provide the medical management according to pathophysiology of the diseases. First, a general overview is given of the pathology, symptoms, diagnostic imaging and key points of treatment from the fetal period to infancy, in accordance with the treatment algorithm in the medical management guide of Congenital Hydronephrosis in Children published by the Japanese Society of Pediatric Urology. It then describes the etiology, definition, classification, diagnosis, medical and surgical treatment, long-term course, and management of congenital hydronephrosis, including ureteropelvic junction obstruction, vesicoureteral reflux, ureterovesical junction obstruction, ureterocele, ectopic ureter, and lower urethral tract obstruction.
Practice Clinical surgery
Keywords
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