体外腎手術による腎内動静脈瘻の治療

Abstract

A case with intrarenal A-V fistula resulting from percutaneous needle biopsy treated by ex vivo renal surgery was presented. A 16-year-old boy had had 2 times biopsies on the left kidney performed as a study for proteinuria. Continuous gross hematuria was a chief complaint. Blood pressure was 130-80 and no nephrosclerosis by histopathologic diagnosis. Transfemoral renal arteriography confirmed the presence of a A-V fistula with saccular type aneurysm in the upper pole of the left kidney. Ex vivo renal surgery was chosen as a curative treatment of A-V fistula and aneurysm. The reason why ex vivo renal surgery was chosen for this case was that A-V fistula was located in the renal cortex of the upper pole near the middle portion associated with saccular type aneurysm. The kidney was transplanted to the ipsilateral iliac fossa. The function of the transplanted kidney was well maintained and gross hematuria disappeared after operation. Indications and operative procedures of ex vivo renal surgery for intrarenal A-V fistula as this case were also discussed.