腎動静脈瘻の1例

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A 29-year-old woman entered the hospital because of hematuria. She had been well until one month previously when a total, gross hematuria occurred with right flank pain. The day before entry the hematuria became more severe and urinary retention developed. The blood pressure was 120/60. The lungs and heart were normal. A distended bladder was felt in the lower abdomen. No bruit was heard. The right costovertebral angle was tender on palpation. The blood examinations were normal except for a low hematocrit (20.5%). A large amount of blood clots were evacuated of the bladder. On cystoscopy bloody stream was seen effluxing from the right ureteral orifice. The IVP showed no function of the right kidney. The contralateral kidney was normal. The RP demonstrated multiple filling defects in the renal pelvis and ureter (Fig. 1). The renal arteriogram disclosed a cluster of small, tortuous, dilated vessels in the lower half of the right kidney with early filling of the inferior vena cava (Fig. 2). A diagnosis of renal arteriovenous fistula was made and nephrectomy was performed. Recovery was uneventful and the patient was discharged on the 43 rd hospital day. The Technovit injected specimen established the diagnosis of arteriovenous fistula (Fig. 3). Histologic examination revealed angiomatous malformation (Fig. 4). This is the 37th case of renal arteriovenous fistula in Japan. Etiology was discussed and the Japanese literature was reviewed (Table. 1).
泌尿器科紀要刊行会の論文

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木下英親
東海大学医学部泌尿器科学

腎動静脈瘻の1例

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