異常血管によって急性増悪した水腎症の成人例

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UPJ(腎盂尿管移行部)閉塞により水腎症が急性増悪した64歳女で,経皮的腎瘻造設に拘わらず,99mTc-DTPA(ジエチレントリアミン五酢酸)レノグラムは非機能パターンを示した.腎摘出を行った.周術期,異常下極血管がUPJを閉塞しているのが認められた.箱の中の形で拡張した腎外腎盂が異常血管からぶら下がっているので,水腎症が急速に悪化したHydronephrosis due to ureteropelvic junction (UPJ) obstruction generally progresses gradually. We experienced a case of hydronephrosis due to UPJ obstruction deteriorating rapidly in an adult woman. In spite of percutaneous nephrostomy, 99mTc-DTPA renogram showed a non-functional pattern. A nephrectomy was done. Peri-operatively, the aberrant lower pole vessel was found to be obstructing the UPJ. The hydronephrosis deteriorated rapidly because the extrarenal pelvis dilated in the shape of box, became suspended from the aberrant vessel. Therefore, we believe that the box pelvis is one of the most important factors deteriorating hydronephrosis.