両側腎皮質壊死の1例

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A 29 year-old gravida 1, par 1 was completely asymptomatic until 36 weeks' gestation. On Oct. 2, 1969, she was admitted to the department of Obstetrics and Gynecology of our hospital because of severe abdominal pain and profuse genital bleeding. Urgent operation by Cesarian section was done with delivery of a dead male fetus. Histerectomy was followed for severe postpartum bleeding. On the next day (Oct.3,1969), she was transferred to our department due to postoperative anuria. Blood pressure was 140/90mmHg. and blood examinations were as follows: RBC279x10^4, Ht.27.1%, WBC12900, serum Na 133mEq/L., K6.8mEq/L., CL87mEq/L., Ca9.0mg/dl., T.P.5.3g/dl., Alb.2.6g/dl., Ureanitrogen 41mg/dl., Creatinine 4.1mg/dl. and CO_2 25mEq/L. Open biopsy on the right kidney performed 28 hours after the onset of genital bleeding revealed a remarkably decreased renal blood flow. Histologically, renal cortex including interstitial cells was almost necrotized. Hyaline-like thrombi filled the capillary loops of glomeruli as well as the interlobular arteries. The characteristic pathological findings were that the thrombi in the interlobular arteries did not pack the lumen completely leavening some spaces.
社団法人日本泌尿器科学会の論文