透析患者にみられた多嚢胞化萎縮腎の自然破裂

Spontaneous Renal Rupture in a Hemodialysis Patient with Acquired Cystic Disease of the Kidney (ACDK):A Case Report

　長期透析患者に発生した多嚢胞化萎縮腎（acquired cystic disease of the kidney）（以下，ACDK）の自然破裂の1例を報告する。症例は68歳，男性。誘因なく突然の側腹部痛，血圧低下にて発症し，CTにて腎周囲血腫を認めた。血管造影検査で腎腫瘍の可能性も否定できず腎摘除術を行ったが，病理学的には悪性所見は認められず，出血の原因としてACDKの自然破裂が考えられた。

A 68-year-old man was referred to our hospital because of sudden onset of hypotension and the right flank pain. He had been maintained on hemodialysis for 9 years. Abdominal CT scan revealed a right perirenal hematoma and multiple cystic lesions on bilateral kidneys. Since renal arteriography showed suspicious findings of the right renal carcinoma, the radical nephrectomy was performed. But pathological examinations revealed no renal carcinoma, and the hematoma was thought to be caused by rupture of ACDK.