膀胱へ穿孔した内腸骨動脈瘤の1例

Abstract

An 81-year-old man was admitted to our hospital with a complaint of dysuria. He had had a right hypogastric aneurysm repaired three years earlier. Physical examination showed a distended soft abdomen and tender mass about the size of a child's head but no murmur was heard over the mass. An excretory urogram (DIP) showed left hydronephrosis and no excretion from the right kidney. Computerized tomography (CT) showed urinary bladder compressed by the mass on the upper right back side. Cystography showed that the large mass occupied the pelvic region with calcification and communicated with the bladder. After a few days, an operation for the aneurysm was undertaken by the surgical department. Although bilateral ureterolysis was possible, a resection of the aneurysm could not be done. The aneurysm was injected with fibrin adhesive and a bilateral nephrostomy was performed. The renal function has been stable and the size of the aneurysm has remained unchanged for 9 months after the surgery.