膀胱出血に対するホルマリン注入後の急性腎不全

ACUTE TUBULAR NECROSIS AFTER INTRAVESICAL INSTILLATION OF FORMALIN: A CASE REPORT

　患者は62歳の女性で，子宮頸癌に対する放射線治療後膀胱出血を来した。種々の治療に抵抗したため尿路変更後4％ホルマリンを膀胱内に注入したところ急性腎不全を発生したが，血液透析で腎機能は回復した。わが国では本例のごとく，急性腎不全を惹起した症例の報告はないが，ホルマリン注入は重篤な合併症が少なくないので適応を限って慎重に行う必要がある。

A 62-year-old female was admitted to our hospital for massive hematuria due to radiation cystitis. Many attempts for hemostasis were all ineffective. As marked bladder hemorrhage continued, formalin solution was instilled into the bladder after jejunal conduit urinary diversion. On the 2nd day after surgery, the patient developed severe oliguria and serum creatinine was elevated. Formalin was thought to be the only cause of acute tubular necrosis. She received 8 hemodialyses and her renal function was restored. This is the first case of acute tubular necrosis after intravesical formalin instillation in Japan.