結石を伴った遺残尿管内蓄膿症の1例

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64歳女.39年前,右尿管結石を伴う右不完全重複腎盂尿管,右低形成腎の診断で,右腎摘出術を施行された.術後も,術前からの膿尿,尿路感染症状が持続し,間欠的に右下腹部痛も出現した.KUBで骨盤腔の膀胱に一致する部位に直径35mmの円形小石灰化像の集塊を,腹部CTでは膀胱右後方に,内部に大小多数の石灰化像と膿尿と思われる腫瘤陰影を認めた.膀胱鏡では軽度肉柱を認めるが,明らかな結石や憩室を認めなかった.以上の所見より,結石を伴った右遺残尿管内蓄膿症と診断し,手術を施行したA 64-year-old woman, who had undergone right nephrectomy because of right incomplete double pyeloureter and dysplastic kidney with a ureteral stone at the age of 25, presented with a chief complaint of repeated urinary tract infection associated with right lower abdominal pain. A diagnosis of empyema of the ureteral stump with multiple stones was made based on X-ray findings and cystoscopy. In December 1999, the right residual ureter and ureteral stones were removed. Histopathologically, non-specific inflammatory change and fibrosis of the wall were observed. The ureter including the stones should have been resected at the previous nephrectomy.