膀胱後腔腫瘍を疑わせた感染性遠位尿管閉鎖症

INFECTIOUS DISTAL URETERAL ATRESIA SUGGESTING A RETRO VESICAL TUMOR

　58歳男性。主訴は排尿痛と頻尿。直腸診で膀胱後面にクルミ大の腫瘤を触知。膀胱鏡で膀胱右側に小鶏卵大の膨隆を認めた。CTを含む画像診断で右腎は存在せず，膀胱後腔腫瘍が疑われた。開腹手術で腫瘤は膿液を内容とする盲端状尿管であつた。右腎は病理学的にも存在せず，尿管遠位側も盲端であり，本症を右無発生腎に合併した遠位尿管閉鎖症と診断した。術前診断の困難な本症に関し，自験例の臨床経過を考察した。

The patient was a 58-year-old male whose complaints were pain upon urination and pollakiuria. Rectal palpation revealed the presence of a large walnut-sized swelling behind the bladder. A smallhen's egg-sized swelling was seen on the right side of the bladder cystoscopically. Image diagnosis, including CT, indicated absence of the right kindney and led to suspected diagnosis of a retro-vesical tumor.