間欠性水腎症の臨床的検討

Abstract

大阪府立母子保健総合医療センターにおいて1991年から1995年迄に手術を施行した先天性水腎症78例のうち, 間欠性水腎症であった5例の臨床的検討を行った.間欠性水腎症の診断と経過観察には, 腹部症状等の症状出現時の超音波検査と利尿レノグラムが有効であった

A clinical study was conducted on the intermittent hydronephrosis in children. Of 78 children with hydronephrosis due to ureteropelvic junction obstruction operated between 1991 and 1995, 5 had intermittent hydronephrosis. All 5 patients were boys between 6 months and 6 years of age. Presenting symptoms were intermittent flank pain and vomiting. Ultrasonography performed during pain attack demonstrated dilation of the renal pelvis in all patients. Diuretic renography demonstrated obstruction in 4 of the 5 children and deterioration of renal function on the affected side in 2. The cause of ureteropelvic junction obstruction was aberrant vessels in 2 cases, fibrous band in 1, ureteral kinking within adventitia in 1 and a ureteral polyp in 1. Postoperatively, all patients have been relieved from the pain. In summary, ultrasonography at the time of symptom attack as well as diuretic renography are useful for the diagnosis and observation of intermittent hydronephrosis.