急速輸液により急性腎不全をきたした両側腎孟尿管移行部狭窄症の1幼児例

Abstract

2歳9ヵ月男児, 脱水により急性腎不全となり, その後の急速な補液負荷が誘因となり両側腎盂尿管移行部の同時性閉塞, 肺水腫が生じたものと考えられ, 一時は生命にも危険を及ぼす腎不全状態となった.その後, 一時的腎瘻のみで腎不全より改善し, 腎瘻造影とWhitaker testにて尿管への通過を認めた為, 手術を施行せず自然経過をみることとした

A 2-year-old boy was hospitalized with the chief complaint of oliguria and dyspnea. Bilateral hydronephrosis and obstruction of the pyeloureteral junction were detected by ultrasonography. Pulmonary edema was also found on chest radiographs. The clinical diagnosis was acute post renal failure due to bilateral pyeloureteral obstruction and pulmonary edema due to overtransfusion. After we performed bilateral percutaneous nephrostomy, the patient recovered from renal failure and pulmonary edema. Both nephrostomies were removed after we confirmed a non-obstructing pattern using the Whitaker test.