尿路への自然破裂を認めた化膿性腎嚢胞

SPONTANEOUS RUPTURE OF INFECTED RENAL CYST INTO PYELOCALYCEAL SYSTEM

　症例は64歳の女性。発熱および右側腹部痛を主訴に受診。USGおよびCTにて右腎上極に辺縁平滑な厚い被膜に覆われた腫瘤を認め，化膿性腎嚢胞と診断した。ドレナージ施行時の嚢胞造影にて尿路への交通を認め，その後交通路は自然閉鎖したため尿路への自然破裂と思われた。治療は，尿路との交通を認めたことから再発の危険性を考慮し，嚢胞壁切除術を行った。

A 64-year-old female was admitted to our hospital because of right flank pain and fever due to right pyelonephritis. Ultrasonography and computed tomogra-phy demonstrated simple cyst of right kidney. Per-cutaneous cystography revealed communication of the cyst to pyelocalyceal system. Renal cystectomy was performed and histological diagnosis was infected renal cyst. This is the 5th case report of spontaneous rupture of infected renal cyst into pyelocalyceal system in Japanese literature.