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両側総腸骨動脈瘤および大腿動脈瘤と診断された78歳の男性。手術目的にて精査中に,右水腎水尿管を発見された.また,単発の乳頭状膀胱腫瘍も合併していた。動脈瘤に対するY型人工血管移植術時の所見で,右尿管は動脈瘤壁に癒着し,当該部位以上の尿管の拡張と右腎実質の著明な菲薄化を認めたため,同時に右腎尿管摘除を行った.動脈瘤に起因する尿管通過障害として自験例は文献上本邦17例目である。
A case of ureteral obstruction due to common iliac arterial aneurysm in 78-year-old man is presented. The chief complaint was an abdominal pulsing mass. Digital angiography and abdominal CT revealed an aneurysm distended from aortic bifurcation to bilateral iliac and femoral arteries associated with obvious right hydronephrosis and hydroureter. A finger tip sized papillary tumor was found near the right ureteral orifice by cystoscopy. The right nephroureterectomy was performed in addition to the grafting operation for the aneurysm. The fibrous adhesion between the ureter and wall of aneurysm was easily dissected.
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