感染性腎嚢胞の尿路への自然破裂

SPONTANEOUS RUPTURE TO URINARY TRACT OF INFLAMMATORY RENAL CYST: A CASE REPORT

　症例は20歳女性。頻尿・熱発・左背部痛を主訴に初診。エコー上左腎に不規則な内部エコーを有する嚢胞を認め，左腎盂腎炎の診断で化学療法後，腎嚢胞に対し経皮的穿刺を予定していたが，入院中誘因なく尿中に膿の排泄を認め，その後腎嚢胞は縮小した。感染性腎嚢胞の，尿路への自然破裂と思われた。膀胱尿管逆流症はみられなかった。CT上腎嚢胞と尿路の交通が証明された。

A 20-year-old female had suffered from pollakisuria, fever, and left back pain for ten days. Ultrasono-gram indicated a left renal cyst with irregular internal echo pattern. Under diagnosis of left pyelonephritis with renal cyst, antibiotics therapy was done. After three days asymptomatically the patient voided the cloudy urine with pus, then the renal cyst was reduced on ultrasonogram. Inflammatory renal cyst assumed to rupture into urinary tract spontaneously. There was no evidence of vesico-ureteral reflux. Computed tomography showed communication of the cyst to urinary tract.