重複尿管に発生した遠位尿管閉鎖症

DISTAL URETERAL ATRESIA OF LOWER MOIETY IN DUPLICATED KIDNEY: A CASE REPORT

　13歳女性。近医で腹痛の精査中，超音波検査，CTにて左下半腎および所属尿管の水腎水尿管症を認めた。経皮的腎盂造影にて膀胱近傍に達する下半腎所属の拡張尿管を認めるも，膀胱は造影されなかった。手術所見で下半腎所属尿管は膀胱近傍で盲端となっており遠位尿管閉鎖症と診断。左下半腎尿管摘出術を行った。病理学的に尿管下端は盲端で，摘出腎は異形成腎であった。下半腎の遠位尿管閉鎖症の報告は本邦2例目である。

A 13-year-old girl presented with abdominal pain. On ultra-sound and CT scan, she was found to have left hydronephrosis of lower moiety in duplicated kidney. Urine analysis and cystoscopy revealed no abnormality. Antegrade pyelography showed significanty dilated ureter of lower moiety in duplicated kidney. Lower end of the ureter reached near the bladder, but no contrast medium was entered in the bladder. In operative findings, the ureter of lower moiety was blind-ended near the bladder, so this case was diagnosed as distal ureteral atresia. Heminephro-ureterectomy was performed.