腎動脈瘤の1例

A CASE OF RENAL ANEURYSM

はじめに

　血管造影法の進歩，普及に伴い腎動脈瘤の報告例が増加している。私たちは最近，腎血管造影により右腎動脈瘤と診断し，in situ renal perfusion法の下に動脈瘤切除を施行したが，腎内血管に血栓を作り止むなく腎摘出を行なった1例を経験したので報告する。

A 61-year-old houswife was admitted with a chief complaint of gross hematuria. The renal angiog-raphy revealed a saccular aneurysm of right renal artery developing from its bifurcation. Under in situ renal perfusion, resection of aneurysm and side-to-side anastomosis was done. Because renal vascular thrombosis occurred after anastomosis, nephrectomy was performed. A cut section of the specimen revealed extensive thrombosis of the intrarenal arteries and veins. Histologically the kidney showed chronic pyelonephritis and vascular media was absent in the aneurysmal wall. Postoperative course was uneventful except for hypertension.