分娩後腎不全を来した両側巨大水腎症

Bilateral Giant Hydronephrosis with Acute Renal Insufficiency after Childbirth

　症例は29歳，女性，初産婦。出産直後より無尿となり，腹部膨満感が出現した。BUN41.1mg／dl,Cr9.9mg／dlと上昇し、腹部CTにて両側巨大水腎症を認めた。腎後性腎不全の診断にて両側尿管カテーテルを留置したところ，水腎症は徐々に改善し，腎不全も軽快した。退院後の逆行性腎盂造影にて，両側腎盂尿管移行部狭窄を認めた。両側腎盂尿管移行部狭窄による水腎症が妊娠のために増悪し，出産後に不可逆的になったものと推測された。

The patient is a 29-year-old woman with her first preg-nancy. Just after delivery, she became anuric with abdominal distention. Laboratory data revealed that she was in acute renal insufficiency. Abdominal CT scan showed bilateral giant hydronephrosis. Under the diagnosis of postrenal failure, we treated her conservatively using ureteral cath-eters. Hydronephrosis became improved, and the renal insufficiency vanished. Retrograde pyelography showed bilateral ureteropelvic junction obstruction. We thought that she had bilateral hydronephrosis due to bilateral ureteropelvic junction obstruction, which was aggravated by pregnancy.