尿路と交通した化膿性腎扁胞

A case of infected renal cyst with communication to renal pelvis

　症例は38歳，女性。主訴は頻尿，発熱，右背部痛。急性腎孟腎炎で入院加療するも改善しなかった。右腎の化膿性腎囊胞を疑い，超音波下穿刺ドレナージを施行し，貯留液は膿液で，約640ml排出，培養でE. coliを検出した。囊胞造影で尿路との交通を認めたが，保存的加療にて改善した。治療後3か月のCT像で，囊胞は著明に縮小していた。化膿性腎囊胞の報告は，調べ得た限りにおいて，本邦で92例を認めるのみであった。

A 38-year-old woman visited our hospital with the complaint of pollakisuria and high fever. A tentative diagnosis of acute pyelonephritis was made,but her symptom was not improved by several antibiotics. Percutaneous puncture and drainage of right renal cyst were performed under ultrasound guidance. The cyst contained 640mlof dark-yellow pus. Bacterial culture of this pus was positive forE. coli.After the drainage of the cyst body temperature rapidly became normal. The cyst was found to have the communication to renal pelvis,but was absorbed following conservative treatment only. Our case is the 93th case of infected renal cyst in the Japanese literatures.（Rinsho Hinyokika 58：247-249,2004）