Parapelvic cyst
Introduction
Introduction to the pararenal cyst Parapelvic cyst (Parapelviccyst) is also called peripelviccyst; the cyst originating from the renal sinus and invading the renal sinus is named parapelvic cyst. The pararenal cysts are mostly caused by congenital factors, the incidence rate is 1% to 3% of renal cysts, and most occur after 50 years of age. Pararenal cysts are usually single, histologically derived from renal parenchyma or old urinary cysts. The above two are commonly referred to as the pararenal cyst. basic knowledge The proportion of illness: 0.025% Susceptible people: no specific population Mode of infection: non-infectious Complications: hydronephrosis kidney damage
Cause
Causes of pararenal cysts
Histologically, the pararenal cysts are divided into two types: urinary and non-urinary, which can be divided into serous and lymphatic. Most of the pararenal cysts are caused by congenital factors, but most patients have a pararenal cyst after the age of 50, and often have a history of urinary tract infection, obstruction or calculus, may be chronic inflammation of the renal pelvis, obstruction, leading to local Lymphatic vessel dilatation, vascular disease of the renal sinus or avascular atrophy of the blood vessels can also cause the effusion to ooze out to the plane of the renal sinus, which is limited to form a serous cyst. Urine-derived cysts may be formed by the extension of the renal parenchymal cyst to the renal hilum.
Prevention
Prevention of pararenal cysts
Cold is one of the most important factors leading to kidney damage in patients with kidney disease. Therefore, we must pay attention to preventing colds in daily life. If we have a cold, we should treat them in time to avoid deterioration.
Excessive intake of protein can lead to the onset and recurrence of chronic kidney disease. Therefore, daily life needs to control diet.
Anemia, high blood pressure, edema, and backache may all be precursors to kidney disease. Be aware of these symptoms.
Strengthen exercise, strengthen blood circulation in the kidneys, help damage repair, and prevent glomerular sclerosis.
Complication
Paralysis of the pararenal cyst Complications hydronephrosis kidney damage
Sometimes there is bleeding in the cyst. When it happens suddenly, it can cause severe pain. The bleeding can come from the cancer on the wall of the cyst. When the cyst is located in the lower pole of the kidney and close to the ureter, it can aggravate hydronephrosis, and the pressure of the urine on the renal pelvis can cause back pain. This obstruction can also cause infection in the kidneys.
Symptom
Symptoms of pararenal cysts Common symptoms Low back pain, kidney area, snoring, hematuria, cold war with high blood pressure
1. Low back pain, waist distension or discomfort: caused by cyst compression of the renal pelvis and ureter to smooth muscle spasm, or cyst growth caused by the coating of the capsule.
2. Hematuria: Smooth muscle spasm can produce microscopic or gross hematuria. When the cyst is ruptured and connected with the renal pelvis, it is a hematuria or even a blood clot.
3. Hypertension: Cyst compression leads to renal ischemia, increased renin and angiotensin.
4. Large cysts or large hydronephrosis can touch the abdominal mass.
5. Infections may have symptoms such as chills, high fever, and pain in the kidney area.
6. If the cyst is small or oppressed, the renal pelvis may be asymptomatic.
Examine
Examination of the pararenal cyst
The disease is more common in patients over 50 years old. The proportion of male and female patients with asymptomatic pararenal cysts is similar, and those with clinical symptoms are more common in males. Clinical manifestations may include lumbar pain and discomfort, hematuria, high blood pressure or associated with intracranial stones, and some patients are asymptomatic and occasionally found during physical examination. According to B-ultrasound, IVU and CT examination can confirm the diagnosis. B-visible has a liquid dark area near the renal gate, and can show the size of the cyst, but when the cyst extends into the renal sinus causing hydronephrosis, or the cyst is located deep in the renal sinus, it is easily misdiagnosed as hydronephrosis. IVU examination can find a circular mass in the renal parasitoid or renal sinus to compress the renal pelvis, renal pelvis or upper ureter, curved indentation, deformation, displacement or elongation, such as cysts and renal pelvis, no traffic, swollen There is no contrast agent, and smaller cysts may have no such changes. CT examination is the most reliable diagnostic method. It can show the elliptical mass with clear and uniform low density near the renal pelvis. The CT value is 02 0HU. The CT value changes little before and after the enhancement, so it can be diagnosed as benign cyst adjacent to the renal pelvis. The pararenal cyst is located in the renal sinus, and the larger cyst can protrude to the renal hilum. The renal cyst is mostly located in the renal cortex, which is round and can be single or multiple. Examination of B-ultrasound and CT is helpful in differential diagnosis.
Diagnosis
Diagnosis and differentiation of pararenal cysts
The initial diagnosis of this disease relies on imaging examination. CT examination is the most positive for the diagnosis of this disease. IVP examination also has a high accuracy in the diagnosis of this disease, and can understand bilateral renal function and renal collecting system morphology. And complications, easy to prompt the space-occupying lesions at the renal hilum should be used as a routine examination. B-ultrasound is sometimes misdiagnosed as hydronephrosis in the diagnosis of this disease, in the B-ultrasound to suggest unexplained hydronephrosis should consider the possibility of the disease, need further examination. The CT scan showed that the cyst was located at the renal hilum, which was separated from the normal renal parenchyma. The lowest density halo formed by the renal sinus fat around the cyst was characteristic of the pararenal cyst. The CT scan of the pararenal cyst can be similar to hydronephrosis, but The enhanced scan is not enhanced, and the developed renal pelvis and renal pelvis are compressed and elongated, which can clear the cyst.
Auxiliary examination of patients with paracrine cysts is clearly diagnosed. The differential diagnosis of the pararenal cyst is as follows:
1, hydronephrosis: hydronephrosis can be caused by the urinary system inside and outside, congenital and acquired multiple factors, can occur in all ages. Patients have no obvious clinical symptoms, and there may be lumbar bulging and abdominal mass when the water is severe. Patients with intermittent hydronephrosis caused by stones, etc. may have renal colic, accompanied by nausea, vomiting, bloating and oliguria. When the water is severe, the examination may touch the enlarged kidney. If the infection is combined, the symptoms of pyuria and systemic infection may occur. Diagnosis mainly depends on ultrasound, IVP, CT and MRI.
2, kidney tumor: is a more common tumor of the urinary system, divided into benign and malignant two types, benign tumors are rare. There are many typical clinical symptoms of benign tumors. When the volume is large, there may be pain and discomfort in the waist and abdomen. The examination may touch the enlarged kidney. Typical clinical manifestations of renal malignancies are hematuria, back pain, and masses. The diagnosis mainly relies on ultrasound, enhanced CT and MRI, etc., and most of them are solid occupying lesions, each with cystic characteristics.
