腎周囲静脈系異常による腎盂尿管静脈瘤の3例

Abstract

Three cases of renal pelvic and ureteral varices have been presented. The patients were admitted to Hiroshima University Hospital with complaint of painless gross hematuria. Cystoscopic examinations revealed renal hematuria without intravesical change, and both excretory and retrograde pyelography showed no particular change, except for renal pelvic and ureteral notching on retrograde pyelography of the 2nd case. Angiographic examinations were performed to make clear the causes of gross hematuria, because conservative treatments for renal hematuria were not effective. Renal pelvic and ureteral varices were demonstrated, in one case by renal phlebography, and in two cases by renal pharmacophlebography. At the time of operations, varices were confirmed in all 3 cases and were ligated with successful results in disapperance of gross hematuria. These cases were complicated with congenital anomalies of venous system, i.e. left inferior vena cava in one case and retroaortic left renal vein in two cases. It seemed likely that pelvic and ureteral varices were caused by congestion of renal and ureteral venous system due to these congenital anomalies. Adding our 3 cases to previous 42 cases, total 45 cases were reviewed, and especially, possible causes of the lesions were discussed including vascular malformation.