Nutcracker現象による腎出血の1例

A CASE OF NUTCRACKER PHENOMENON PRESENTING LEFT RENAL HEMATURIA

緒言

　最近，特発性腎出血の原因の一つとして，腎静脈の還流異常が注目されている。われわれの経験した症例は，上腸間膜動脈および腹部大動脈前面の索状組織が左腎静脈を圧迫し，いわゆるnutcra—cker現象によつて血尿を呈していたもので，手術的治療に成功した。以下若干の文献的考察を加えて報告する。

The patient was 20-year-old man complaining gross hematuria persisting for the past 2 years. Markeddilatation of the left renal vein was observed in a series of computed tomography. Selective renal angiography revealed the left renal vein compressed between superior mesenteric artery and abdominal aorta. On February 20, 1984, the left renal vein was reanastomosed 1.5cm caudal to the inferior vena cava, and a Dacron pillow with a size of 20×12×8mm was placed at the angular portion bet-ween the superior mesenteric artery and the aorta. Hematuria gradually faded out and completely disappeared in 53 postoperative days.