下大静脈後尿管に対する下大静脈整復術の経験

EXPERIENCE OF VENA CAVAL DIVISION AND REANASTMOSIS IN RETROCAVAL URETER

Ⅰ．はじめに

　下大静脈後尿管は胎生期に起こつた下大静脈の発生異常によるもので，従来比較的稀な疾患とされていた。しかし近年に至り泌尿器科学の急速な発展，とくにそのレ線学的診断法の進歩により本疾患の発見が容易となつたため，ことにここ数年来多数の症例が報告されるようになつた。岸本・岡田（1966）^1）によれば本邦ですでに46例の報告があり，しかもその3分の2はそれまでの5年間になされたものであるという。我々も最近本症の1例を経験し，下大静脈の切離再縫合による尿管整復術を行ない，満足すべき結果を得たので報告する。

A 29 years old male visited our clinic with the chief complaint of right flank pain. Retrograde pyelography and venacavography was performed, since poor functioning right kidney was noticed after passing a small calculi spontanously, and retrocaval ureter was confirmed.

On march 16, 1967 the vena cava was amputated and reanastomosed after restoring the ureter to itsnormal course and remarkable improvement of right hydronephrosis was seen after 2 months, This type of surgery has been done in only a few cases since Goodwin et al (1957) and only 6 cases are reported in Japan after Inoue (1959), but 100% success has been obtained.