Left in vitro lithotripsy of ureteral calculi one cases of acute intestinal obstruction.docVIP

 PAGE \* MERGEFORMAT 5 Left in vitro lithotripsy of ureteral calculi one cases of acute intestinal obstruction Author: Ho Yang, Zhang Yuan-Bo, ZHOU Rong-bin, WU Ai-hui [Keywords:] Ureteral calculi; Lithotripsy; acute intestinal obstruction Patients, male, 43 years old. Left lower abdominal cramps accompanied by vomiting and 2 h. Examination: abdomen flat, tight abdominal muscles, the left lower abdomen with tenderness, tapping the left kidney area pain with gross hematuria. OK B-shows left lower ureter with a 0.6 cm * 0.6 cm stone, and with left hydronephrosis, diagnosed as ‘left ureteral stone’, carry out extracorporeal shock wave lithotripsy, the working voltage of 9 ~ 10 kV, the impact of 900 times. The anti-infection, spasm, bleeding and other treatment, in the afternoon see the mud-like debris discharged. 3 d after the abdominal pain, persistent and increasing abdominal distention, nausea, vomiting two times, vomit stomach contents, no defecation, exhaust 1 times, self-inductance fever. Palpation: T: 38.9 ℃ , P 86 times / min, BP 150/90 mmHg (1 mmHg = 0.133 kPa), pain expression, buckling position. Coarse breath sounds lungs have not heard, and wet and dry rales. Qi rhythm, heart rate 86 times / min, the valve auscultation area is not known and pathological murmur. Whole abdominal bulging, no gastrointestinal type and peristaltic wave, full abdominal tenderness, rebound tenderness weak positive, reduced bowel sounds, the vibration of water sounds positive, normal liver dullness sector without knocking, and shifting dullness, left abdomen and can be heard a high-profile air over the water sounds. KUB: See the small intestine over the first group of gas-liquid 3,4-plane. Blood count WBC 14.04 * 109 / L, N 0.87; urine WBC 2 ~ 8/HP. B-urinary system showed no abnormality. Diagnosed as ‘obstruction’. Treatment: to be fast water, continuous gastrointestinal decompression, anti-infection, acid suppression, supplementary electrolytes and other symptomatic treat