Chiari malformation type 1 (CM1) is a rare condition where agreed classification and treatment are still missing. In 2019, 34 international experts from Europe achieved a consensus on the definition, diagnosis, and treatment of CM1 in children, aiming to guide the clinical diagnosis and treatment of CM1 in children. Now the consensus is interpreted based on recent international research achievements, aiming to provide references for accurate clinical assessment and individualized treatment of CM1 in children.

Chiari malformation (CM) is the most common cause of syringomyelia, where agreed criterions on classification and treatment are still missing. In 2019, 29 international experts from Europe achieved a consensus on the definition, classification, diagnosis and treatment of CM and syringomyelia in adults, aiming to guide the clinical diagnosis and treatment of these diseases. Now the consensus is interpreted based on recently published literature at home and abroad, aiming to provide references for standardized diagnosis and treatment of CM and syringomyelia in adults.

Chiari malformation (CM) is the most common cause of syringomyelia, where agreed criterions on classification and treatment are still missing. In 2019, 29 international experts from Europe achieved a consensus on the definition, classification, diagnosis and treatment of CM and syringomyelia in adults, aiming to guide the clinical diagnosis and treatment of these diseases. Now the consensus is interpreted based on recently published literature at home and abroad, aiming to provide references for standardized diagnosis and treatment of CM and syringomyelia in adults.

[Objective] To investigate the clinical manifestations and explore the experience of diagnosis and treatment of spontaneous perirenal urine extravasation after urinary tract obstruction so as to improve the understanding of the disease. [Methods] The clinical data of 23 patients with spontaneous perirenal urine extravasation after obstruction treated at our hospital during 2018 and 2020 were retrospectively analyzed, including the primary diseases, clinical manifestations, imaging examination, treatment and prognosis. The key points of diagnosis and treatment were summarized. [Results] Of the 23 patients, there were 15 males and 8 females, with an average age of 43.4 years. These cases were diagnosed by imaging tests such as ultrasound, computed tomography urography (CTU) and CT. Ureteroscopic lithotripsy was performed in 3 patients with ureteral calculi, retrograde ureteral catheterization in 4 patients and percutaneous nephrostomy in 13 patients. Afterwards, a second phase surgery was performed based on the patients' condition. Of the 3 patients with tumor metastasis who underwent retrograde ureteral catheterization, 2 operation were successful, and 1 operation failed and then converted to nephrostomy and drainage under B-ultrasound localization. [Conclusion] CTU should be performed as soon as possible to make a definite diagnosis. Treatment can be achieved with ureteral retrograde catheterization or percutaneous nephrostomy to achieve local decompression, followed by secondary surgery to treat the primary cause of obstruction.