腎梗塞を繰り返した腎動脈瘤

A case of renal artery aneurysm with recurrent episodes of renal embolism

　症例は79歳，男性。2002年6月に右腎動脈瘤の確定診断が得られたが，無症候性であったため患者は手術を希望せず降圧剤，抗血小板剤などの投与で経過観察中であった。2003年9月，右側腹，回盲部痛と発熱をきたし，CTスキャンで右腎中央から下極にかけての腎梗塞と診断された。約2週間の経過で症状は改善したが，1か月後に新たな腎梗塞をきたし，梗塞によるダメージと年齢を考慮し右腎摘除術を施行した。

A renal artery aneurysm of right kidney was incidentally discovered in a 78-year old man in June 2002. As he was asymptomatic,he did not expect surgical interventions,and then he had been followed conservatively for 15months. In September 2003,he suffered from right flank pain and fever,and laboratory studies showed leukocytosis and elevated serum LDH levels. A CT scan revealed renal infarction of right kidney and thrombi formation in the aneurysm. After a short period of convalescence renal infarction occurred again one month later. Corsidering the renal damage by recurrent renal infarction and his age（79-year old）,right nephrectomy was performed,and postoperative course was uneventful.