回腸導管の細菌性炎症による両側水腎症

BILATERAL HYDRONEPHROSIS DUE TO BACTERIAL INFLAMMATION IN THE ILEAL CONDUIT: A CASE REPORT

　7年前に膀胱腫瘍のため回腸導管を造設された73歳の女性が，血尿，発熱，腹痛を訴えて受診した。排泄性尿路造影では両側の水腎症を認めた。原因として細菌による回腸導管内の炎症が考えられたため，感受性のある抗生剤を投与したところ水腎症は消失した。本症の誘因として，回腸導管が過長であることや術後再発に対して行われた放射線療法が推定された。

A 73 year-old female presented to our hospital complain-ing of gross hematuria, fever and abdominal pain. She had a history of bladder cancer and had undergone total cystectomy with ileal conduit formation seven years previously. Drip infusion urography revealed bilateral hydronephrosis. We diagnosed that the hydronephrosis was caused by bacterial inflammation in the ileal conduit. Hydronephrosis and her symptoms disappeared by sensi-tive antibiotics. That her ileal conduit was too long and previous radiotherapy given to her to prevent recurrence of bladder cancer were thought responsible for this episode.