腎周囲リンパ管遮断術により治癒した乳糜尿の1例

Abstract

54歳男.保存的治療に反応せず急速に低蛋白血症が進行し尿閉を繰り返したが, 腎周囲リンパ管遮断術により治癒した両側乳糜尿の1例について, 若干の文献的考察を加え報告した

A 54-year-old male was referred to our outpatient clinic because of milky urine. He had lived in Kumamoto, an area of endemic filariasis. There were no microfilaria found in his blood smear. Lymphangiography showed dilation of the retroperitoneal lymphatics and bilateral renal refluxes. The thoracic duct was obvious. The initial treatment consisted of irrigating the bilateral renal pelvis with silver nitrate solution, but was not successful and recurrent acute urinary retention developed. Therefore, we performed stripping and ligation of the bilateral renal lymphatics. Chyluria disappeared immediately after surgery. The etiology and various treatments for chyluria are discussed.