子宮内膜症による両側水腎症

A CASE OF BILATERAL HYDRONEPHROSIS DUE TO ENDOMETRIOSIS

　34歳，主婦．右側腹部痛・肉眼的血尿を主訴に近医受診．IVPにて両側水腎症を認め当院転院となる．入院時，軽度の貧血と腎機能障害，CA−125の中等度上昇を認めた．画像診断では，異常陰影による骨盤内尿管の狭窄と上部尿路の拡張を認めた．外性子宮内膜症に伴う両側水腎症と診断，腹式単純子宮全摘出術・両側付属器切除術・術中両側尿管カテーテル挿入を行った．術後水腎症と腎機能は改善した．

A 34-year-old woman with complaints of the right flank pain and macroscopic hematuria had a bilateral hydroureteronephrosis. Mild anemia and renal dysfunction were also presented when she was admitted. The further radiologic studies revealed a periureteral mass to cause bilateral hydroureteronephrosis. Endometri-osis was suspected because of the mild elevation of CA-125 from the sereal studies. The diagnosis was comfirmed after the surgical treatment, a combination surgery of simple hysterectomy, bilateral oophor-ectomy and ureteral stenting. The renal dysfunction disappeared thereafter.