高血圧を伴った小児腎動脈瘤の1例

Abstract

Renal artery aneurysm is relatively rare. Only 31 cases in Japan, while more than 300 cases in the world, have been previously reported. An 11-year-old girl was admitted to our hospital with complaints of hypertension, fever and tremor of extremities. Physical examination revealed no significant change except for hypertension (180/130 mmHg). Intravenous urography demonstrated that the right kidney was obviously contracted, and renal angiography revealed an aneurysm at the bifurcation of the right renal artery. The plasma renin activity was 100ng/10 cc/4 hrs at rest and 171ng/10 cc/ 4 hr on exertion. The right kidney was explored and removed. A cut section of the specimen revealed a saccular aneurysm containing blood clots, and the histological examination demonstrated defect of media of the aneurysmal wall. The patient did well after operation and the blood pressure was stable within normal range for 3 postoperative years. The cases of renal artery aneurysms in Japan were reviewed, and the causes of underlying hypertension were discussed.