結石を伴つた残存尿管蓄膿症

EMPYEMA OF URETERAL STUMP WITH A STONE

　脊髄炎による神経因性膀胱の54歳，男性に，発熱を伴う難治性尿路感染症を認めた。33歳時，腎結石症のため右腎摘出術を受けている。排泄性尿路造影，膀胱造影で，結石を伴う右残存尿管への逆流像を認めた。1986年，残存尿管蓄膿症の診断下に残存尿管摘出術を施行した。摘出標本は非特異的慢性炎症像を示し，悪性所見を認めなかつた。この事実より膀胱尿管逆流現象を認める側の腎摘出の際は，腎尿管全摘出術が望ましいと考えられた。

A 54-year-old man who had neurogenic bladder due to myelitis was presented with a chief com-plaint of resistant urinary tract infection associated with fever attacks. At the age of 33, he received rt. nephrectomy because of rt. renal calculi. Excretory urogram and cystogram revealed the reflux of the contrast medium into the ureteral stump with a stone. In 1986 rt. residual ureterectomy was per-formed under the diagnosis of empyema of ureteral stump with a stone. Histologically, there were non-specific chronic inflammatory change and no malignancy.