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Title: 遺残虫垂に発生したエンドメトリオーシスによる右尿管狭窄の1例(Right Ureteral Stenosis Due to Endometriosis Occurring in the Residual Appendix: Report of a Case)
Other Titles: Right ureteral stenosis due to endometriosis occurring in the residual appendix: report of a case
Authors: 松本, 成史  KAKEN_name
南, 高文  KAKEN_name
西岡, 伯  KAKEN_name
秋山, 隆弘  KAKEN_name
前倉, 俊治  KAKEN_name
Author's alias: MATSUMOTO, Seiji
MINAMI, Takafumi
AKIYAMA, Takahiro
Keywords: Endometriosis
Ureteral stenosis
Issue Date: Dec-2000
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 46
Issue: 12
Start page: 903
End page: 905
Abstract: 48歳女.3年前に他院にて右卵巣嚢腫・子宮筋腫の診断で,右卵巣摘出術・子宮摘出術を受け,術中虫垂にまで波及する癒着を認め,虫垂切除術も受けている.今回,半月ほど前より右側腹部痛が出現し,近医における超音波検査で右水腎症を指摘され紹介来院した.排泄性・逆行性腎盂造影にて右水腎尿管症と右下部尿管の狭窄像を認め,同部位の尿細胞診はclass IIIaであり,右尿管腫瘍も否定できないため手術目的で入院となった.全身麻酔下に右傍腹直筋切開で後腹膜腔に達したところ,前回手術による癒着を広範囲に認め,右尿管狭窄部位が特に癒着が強く,腹膜まで癒着は続いていた.腹膜を開放すると回盲部を中心に癒着しており,虫垂切除断端部分が腫瘤の中心であったため,この部分を一塊として摘出した.摘出標本の病理組織学的所見から本症例は虫垂遺残部位にエンドメトリオーシスが再発し,後腹膜腔まで炎症が波及し右尿管狭窄をきたしたと診断された
A 48-year-old female was found to have right flank pain at another hospital and transabdominal ultrasonography showed right hydronephrosis. She was referred to our department for further examination. She had undergone right oophorectomy and total hysterectomy 3 years before. Intravenous pyelography showed right hydronephrosis and retrograde pyelography revealed ureteral stenosis at the lower portion of the right ureter. Endometriosis had developed at the site of previous surgery on the appendix. A mass was formed in an extensive area including the endometriotic lesion, due to adhesion following previous surgery or other reasons, and extended to the retroperitoneum, thereby inducing right ureteral stenosis. The postoperative course was uneventful. The pathological diagnosis was endometriosis of the residual appendix.
PubMed ID: 11211809
Appears in Collections:Vol.46 No.12

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