title: [Repair of right ureteral stenosis by traumatic injury with appendiceal interposition: a case report].
abstract: We report a repair of a right ureteral stenosis with the appendix as a ureteral substitute. A 20-year-old male suffered a traumatic injury in a motorcycle accident. He underwent an emergency operation for right hemothorax, intraabdominal hemorrhage, and bone fracture of right leg. Three weeks later, right hydronephrosis and urinoma were identified. Combined retrograde and antegrade pyelography demonstrated a severe 7 cm long stenosis in the right upper ureter. After an indwelling right nephrostomy catheter was placed, he returned to the hospital for a ureteral reconstruction. We planned to substitute the appendix to bridge the stenotic ureter. After transecting the appendix from the cecum, the mesoappendix was spatulated from mesoileum. Ureteral tissue was resected and appendix was interposed. Three weeks later, ureteral stent was removed. DTPA diuretic renogram scintigraphy demonstrated no evidence of obstruction five weeks later. Two years postoperatively, the patient was asymptomatic and his renal function was normal. Although only few cases of ureteral repair with appendix are known, uretero-appandix replacement is less invasive and complicated, and recommended in some cases.
authors.affiliation: Department of Urology, Shiga University of Medical Science. murairyosuke@me.com
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Murai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ushida
authors.forename: Takashi
authors.initials: T
authors.lastname: Osafune
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Johnin
authors.forename: Susumu
authors.initials: S
authors.lastname: Kageyama
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Okada
mesh_terms: D000063:Accidents, Traffic; D001065:Appendix / Q000637:transplantation*; D003251:Constriction, Pathologic; D006801:Humans; D008297:Male; D019919:Prosthesis Implantation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D014513:Ureter / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D014517:Ureteral Obstruction / Q000209:etiology* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D055815:Young Adult