糖尿病に合併した気腫性腎盂腎炎

A CASE OF EMPHYSEMATOUS PYELONEPHRITIS ACCOMPANIED WITH DIABETES MELLITUS

　44歳，女性．糖尿病の治療中，右側気腫性腎盂腎炎を発症した．嘔気，嘔吐，右側腹部痛で発症し，腹部CTにて腎盂腎杯に認められた異常ガス像で診断した．保存的治療にも全身状態は改善しないため，14病日，右側単純腎摘出術を施行した．しかし手術直後に敗血症性ショックで死亡した．気腫性腎盂腎炎は稀な疾患であるが，時に致死的である．このため早期発見，積極的な内科的外科的治療が重要となる．

We report the case of a 44-year-old diabetic woman with emphysematous pyelonephritis. The patient presented with nausea, vomiting, and right flank pain. The diagnosis was established by abdominal CT. Despite of aggressive supportive therapy, the patient became critically ill. On the 14th day of admission, right nephrectory was carried out. But the patient died one hour after the nephrectomy. Emphysematous pyelone-phritis is often fatal. Survival rate depends on early diagnosis and aggressive combined medical and surgical management.