術前診断が腎異常血管に起因する水腎症であった旁腎盂嚢腫の1例

Abstract

A case of peripelvic cysts of the kidney in a 58-year-old male was reported. For 3 months he had suffered from dull pain in the left lumbar region, which was increased by bodily motion. Laboratory findings were within normal limits. A left pyelogram showed a dilatation of the pelvis and calices and excretion of contrast medium stopped at the point of the pelviureteral junction, where selective arteriogram demonstrated renal aberrant arterial branch. According to these findings, this case was diagnosed as hydronephrosis caused by the aberrant vessel. On operation, however, two peripelvic cysts were discovered. One cyst about 5 cm in diameter extended downward compressing the pelvis and ureter anteriorly and renal parenchyma. Another cyst about 3 cm in diameter laid between the renal pelvis and vascular pedicle and pushed forward the pelvis. So the pelvis and the ureter compressed by the cysts was dilated. The aberrant vessel did not compress the pelvis. The cysts containing clear, light yellow fluid were excised. Pathological examination showed the wall of the cysts being composed of smooth, fibrous connective tissue. On follow up urograms, compressed renal parenchyma was found to be restored with better excretory function but there remained some dilatation of the calyceal system. However, the dull pain has greatly improved.