Ihe nkwụsị UPJ

Ureteropelvic junction (UPJ) mgbochi bụ mgbochi na ebe akụkụ nke akụrụ na-arapara na otu nke tub na eriri afo (ureters). Nke a na - egbochi mmamịrị si na akụrụ.

Ihe mgbochi UPJ na-aputakarị na ụmụaka. Ọ na-emekarị mgbe nwa ka na-eto eto n’akpa nwa. A na-akpọ nke a ọnọdụ ebumpụta ụwa (nke sitere n'oge ọmụmụ).

A na-egbochi mgbochi mgbe enwere:

• Ebe dị warawara n'etiti ureter na akụkụ akụrụ a na-akpọ renal pelvis
• Ọbara na-adịghị ahụkebe nke na-agafe ureter

N'ihi ya, mmamịrị na-eto ma na-emebi akụrụ.

N’ime ụmụaka ndị toworo eto na ndị toworo eto, nsogbu ahụ nwere ike ịbụ n’ihi ịcha ahịhịa, ọrịa, ọgwụgwọ ndị gara aga maka mgbochi, ma ọ bụ nkume akụrụ.

Ihe na-egbochi UPJ bụ ihe na-akpata urinary mkpọchi ụmụaka. A na-ahụkarị ya tupu amụọ ya na ule ultrasound. N'ọnọdụ ụfọdụ, ọnọdụ ahụ nwere ike ọ gaghị apụta ruo mgbe amụrụ nwa. Maywa ahụ nwere ike ịdị mkpa na nwata ma ọ bụrụ na nsogbu a dị njọ. Imirikiti oge, anaghị achọ ịwa ahụ ruo oge ọzọ. Fọdụ ọnọdụ anaghị achọ ịwa ahụ ma ọlị.

E nwere ike ọ gaghị enwe ihe mgbaàmà ọ bụla. Mgbe ihe mgbaàmà pụtara, ha nwere ike ịgụnye:

• Azụ ma ọ bụ azụ mgbu karịsịa mgbe ị na-a consumụ ọgwụ diuretics dị ka mmanya ma ọ bụ caffeine
• Mmamịrị ọbara (hematuria)
• Mgwakota afọ (afọ uka)
• Akụrụ ọrịa
• Ọganihu na-eto eto na ụmụ ọhụrụ (enweghị ike ime nke ọma)
• Urinary tract ọrịa, na-enwekarị ahụ ọkụ
• Akpịrị

Ultrasound n'oge afọ ime nwere ike igosi nsogbu akụrụ na nwa ebu n'afọ.

Ule mgbe amuchara nwa nwere ike igunye:

• BUN
• Nwepu okike
• Nyocha CT
• Elektrik
• IVP - ejighi ya
• CT urogram - nyocha nke akụrụ na ureters na ọdịiche IV
• Nyocha nuklia nke akụrụ
• Idingbula cystourethrogram
• Ultrasound

Gerywa ahụ iji mezie ihe mgbochi na-enye ohere ka mmamịrị na-agagharị na ya. Ọtụtụ oge, a na-eme ịwa ahụ na-emeghe (invasive) na ụmụ ọhụrụ. Enwere ike iji usoro ndị na-adịghị emerụ ahụ emeso ndị okenye. Usoro ndị a gụnyere obere ịwa ahụ karịa ịwa ahụ, ma nwee ike ịgụnye:

• Usoro Endoscopic (retrograde) anaghị achọ ịwa ahụ na akpụkpọ ahụ. Kama nke ahụ, a na-etinye obere akụrụngwa n'ime ure ahụ na eriri afo yana n'ime akpa ahụ metụtara. Nke a na-eme ka dọkịta na-awa ahụ mepee mgbochi site n'ime.
• Usoro Percutaneous (antegrade) gụnyere obere ịwa ahụ n'akụkụ akụkụ ahụ n'etiti ọgịrịga na hip.
• Pyeloplasty na-ewepu anụ ahụ dị nro site na mpaghara ahụ egbochiri ma weghachite akụkụ ahụ dị mma nke akụrụ na ureter dị mma.

Ejikwala laparoscopy na-agwọ ihe mgbochi UPJ na ụmụaka na ndị toro eto na-enwebeghị ihe ịga nke ọma na usoro ndị ọzọ.

Enwere ike itinye tubụ akpọ stent ka ọ gbapụ mamịrị site na akụrụ ya ruo mgbe ịwa ahụ gwọọ ya. Akwara nephrostomy, nke a na-etinye ya n'akụkụ ahụ iji kpochapụ mmamịrị, nwekwara ike ịdị mkpa maka obere oge mgbe ịwachara ahụ. Maydị tube a nwekwara ike iji gwọ ọrịa ọjọọ tupu ịwa ahụ.

Chọpụta na ịgwọta nsogbu ahụ n’oge nwere ike inye aka gbochie mmebi akụrụ n’ọdịnihu. Ihe mgbochi UPJ nke a chọpụtara tupu a mụọ ya ma ọ bụ n'oge a mụrụ ya nwere ike ịbawanye n'onwe ya.

Imirikiti ụmụaka na-eme nke ọma ma ha enweghị nsogbu ogologo oge. Mmebi siri ike nwere ike ịdapụta na ndị mmadụ achọpụtara n’oge na-adịghị ndụ.

Ogologo oge ga-esi na ọgwụgwọ dị mma ugbu a. Pyeloplasty nwere ihe ịga nke ọma kachasị mma.

Ọ bụrụ na edozighị ya, nkwụsị UPJ nwere ike ibute nkwụsị ọrụ akụrụ na-adịgide adịgide (akụrụ akụrụ).

Nkume akụrụ ma ọ bụ ọrịa nwere ike ime na akụrụ emetụta, ọbụlagodi mgbe a gwọchara ya.

Kpọọ onye nlekọta ahụike ma ọ bụrụ na nwa ọhụrụ gị nwere:

• Mmamiri ọbara
• Ahụ ọkụ
• Akpụ akpụ n’afọ
• Ihe ngosi nke mgbu azụ ma ọ bụ ihe mgbu na akụkụ ahụ (mpaghara ahụ n'akụkụ akụkụ ahụ n'etiti etiti ọgịrịga na pelvis)

Ureteropelvic nkwụsị ụzọ; UP nkwụsị ngọngọ; Mgbochi nke ureteropelvic nkwụsị

• Akụrụ anatomi

Okenye JS. Mgbochi nke urinary tract. Na: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Akwụkwọ ọgụgụ nke Ọrịa edimụaka. 21nke. Philadelphia, PA: Elsevier; 2020: isi 555.

Frøkiaer J. Urinary tract mgbochi. Na: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner na Rector nke akụrụ. Nke iri. Philadelphia, PA: Elsevier; 2016: isi 38.

Meldrum KK. Pathophysiology nke urinary tract igbochi. Na: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Ulology nke Campbell-Walsh. Nke 11. Philadelphia, PA: Elsevier; 2016: isi 48.

Nakada SY, kacha mma SL. Nchịkwa nke urinary tract mgbochi. Na: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Ulology nke Campbell-Walsh. Nke 11. Philadelphia, PA: Elsevier; 2016: isi 49.

Stephany HA, Ost MC. Ọrịa Urologic. Na: Zitelli BJ, McIntire SC, Nowalk AJ, eds. Zitelli na Davis 'Atlas nke nyocha umuaka umuaka. Nke 7. Philadelphia, PA: Elsevier; 2018: isi 15.