腎静脈弁の1例

Abstract

A case of renal vein valves which was supposed to be the cause of gross hematuria was reported and discussed in reference to the English literatures. A 32-year-old man was admitted with asymptomatic gross hematuria. Physical examinations and laboratory data were within normal limit. Cystoscopic examination showed no abnormal findings except for hematuria through the left ureteral orifice. Although DIP and RP were normal, left renal venogram demonstrated that there were two main renal veins and thin and sharply defined filling defects in the origin of each vein which were due probably to the renal vein valves. No case of renal vein valve has been reported in Japan, although there have been many in English literatures, in which the authors concluded such renal vein valve did not play any pathologic role for hematuria. In our case, however, the valves might have caused renal congestion for the following reasons, which led to gross hematuria: 1) The appearance of the valves was concave toward the renal hilus of which direction was against the blood stream. 2) The remarkably dilated and tortuous lumbar vein was found in renal venography. 3) Contrast medium in the renal vein still remained even 13 sec after the injection without the use of vasoconstrictor into the renal artery. 4) Renal arteriography demonstrated only 3 collateral veins but main renal veins were not visualized in venous phase.