新生児期に急性腎不全を呈した両側異所開口尿管の1例
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急性腎不全及び両側水腎症のために日齢2に右腎瘻が増設された日齢20の男児で,排尿時膀胱尿道造影で両側膀胱尿管逆流(右側;グレードI,左側;グレードV)を認め,腎臓シンチグラフィーで左側低異形成腎が明らかにされた.内視鏡検査で両側異所開口尿管を認め,右側は後部尿道,右側は膀胱頸部にそれぞれ開口していた.日齢40日に両側尿管縫縮術を伴う両側尿管膀胱吻合術を行った.術後経過は順調で,血清クレアチニン値は術後6ヵ月に0.5mg/dlに改善したA male neonate was referred to our institute after the placement of right nephrostomy because he presented syndrome of acute renal failure and bilateral hydronephrosis. Voiding cystourethrography revealed bilateral vesicoureteral reflux (right.; grade I, left.; grade V), and renal scintigraphy revealed left hypodysplastic kidney. Endoscopy revealed bilateral ectopic ureters; posterior urethra on the right and bladder neck on the left. We performed bilateral ureterocystoneostomy with bilateral ureteral folding. Postoperative course was uneventful, and the serum creatinine improved to the level of 0.5 mg/dl 6 months after the intervention.
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