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51歳,女性.右背部痛を主訴に当院内科を受診.超音波検査で右腎被膜下血腫を疑われ,当科を紹介された.DIP,逆行性腎盂造影,CTで右腎被膜下血腫,水腎症,尿管狭窄を認めた.入院後の検索で上行結腸癌,その肝転移が疑われ,上行結腸癌の尿管浸潤による腎被膜下血腫,水腎症と診断.回盲部切除,右腎尿管摘出術を施行した.病理診断は上行結腸の中等度分化型腺癌,その尿管および後腹膜腔浸潤で,腎では被膜下に出血を認めた.
A 51-year-old woman visited our hospital with a chief complaint of the right back pain. A subcapsular renal hematoma was suspected by ultrasonography. An excretory urography and retrograde pyelography revealed a right hydronephrosis and ureteral stricture. A computerized tomography demonstrated a probable right subcapsular renal hematoma. We found that she had carcinoma of the ascending colon with liver metastases which caused the subcapsular renal hematoma by ureteral invasion. Ileocecectomy and right nephroureterectomy were performed.
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