神経因性膀胱患者に発生した傍腎性仮性嚢胞

A CASE OF PARARENAL PSEUDOCYST IN A PATIENT WITH NEUROGENIC BLADDER

　65歳女性。6年前の子宮頸癌手術後神経因性膀胱となり，間欠的自己導尿法を行つていたが，7ヵ月前から発症したパーキンソン症候群および多発性脳梗塞のため自己導尿継続が困難となつた。その後，右傍腎性仮性嚢胞を発生した。腎盂内圧上昇による腎周囲への尿溢流が原因と思われた。手術的ドレナージにより仮性嚢胞は治癒したが，自己導尿再開は困難なため尿道留置カテーテルとなつた。

A 65-year-old woman who had neurogenic bladder for the past 6 years due to radical hysterectomy for uterine cervical cancer was admitted to our hospital complaining of abdominal pain. She had been successfully treated with intermittent self-catheterization until seven months before, when she could not continue self-catheterization and was diagnosed as having Parkinsonism and multiple brain infarction. She had a marked leukocytosis and uremia. Ultrasonic examination revealed bilateral hydronephrosis and CT disclosed a cystic mass surrounding the right kidney.