結石を伴った遺残尿管内蓄膿症の1例

Abstract

64歳女.39年前, 右尿管結石を伴う右不完全重複腎盂尿管, 右低形成腎の診断で, 右腎摘出術を施行された.術後も, 術前からの膿尿, 尿路感染症状が持続し, 間欠的に右下腹部痛も出現した.KUBで骨盤腔の膀胱に一致する部位に直径35mmの円形小石灰化像の集塊を, 腹部CTでは膀胱右後方に, 内部に大小多数の石灰化像と膿尿と思われる腫瘤陰影を認めた.膀胱鏡では軽度肉柱を認めるが, 明らかな結石や憩室を認めなかった.以上の所見より, 結石を伴った右遺残尿管内蓄膿症と診断し, 手術を施行した

A 64-year-old woman, who had undergone right nephrectomy because of right incomplete double pyeloureter and dysplastic kidney with a ureteral stone at the age of 25, presented with a chief complaint of repeated urinary tract infection associated with right lower abdominal pain. A diagnosis of empyema of the ureteral stump with multiple stones was made based on X-ray findings and cystoscopy. In December 1999, the right residual ureter and ureteral stones were removed. Histopathologically, non-specific inflammatory change and fibrosis of the wall were observed. The ureter including the stones should have been resected at the previous nephrectomy.