クローン病,潰瘍性大腸炎に合併した尿路結石の4例

Abstract

炎症性腸疾患に尿路結石が合併した。4症例ともに手術症例で, 全大腸切除を行った2例で尿酸結石, 回腸切除(1m)を行った1例と, 回腸切除(1m)と全大腸切除を行った1例で蓚酸カルシウム結石であった。4例すべてに尿pHの低下を, 3例に尿量の減少を認めた。回腸切除を行った2例は腸管性高蓚酸尿症であり, 蓚酸負荷試験で尿中蓚酸排泄量の亢進を認めた

We report 4 cases of urinary lithiasis associated with chronic inflammatory bowel disease. All cases were surgically treated and the mode of operation was total colectomy in two cases, ileal resection (1 m) in 1 case and total colectomy and ileal resection (1 m) in 1 case. The composition of the stone was uric acid in 2 cases treated with total colectomy and calcium oxalate in the other 2 cases treated with ileal resection. Low urine volume was observed in 3 cases and acid urine in all cases. Hypocitruria was observed in 3 cases. Two cases with ileal resection showed enteric hyperoxaruia and increased urinary excretion of oxalate was observed on the oxalate loading test.