腎盂尿管移行部狭窄を伴う骨盤腎

URETEROPELVIC JUNCTION OBSTRUCTION OF PELVIC KIDNEY

　70歳，女性が右下腹部痛のため当科を受診した。X線学的検査にて，右骨盤腎に合併した腎盂尿管移行部狭窄水腎症と診断した。腹膜外的到達法にて腎盂形成術を行い，術後尿流は良好となり疼痛発作は消失した。文献的には骨盤腎は稀な尿路奇形であり，治療として腎摘除術が多く施行されていたが，解剖学的に正常位置の腎と同様に腎保存手術を施行すべきと考えた。

A 70-year-old woman was consulted to our hospital complaining of right lower abdominal pain. X-ray exami-nations revealed right pelvic kidney with hydronephrosis due to ureteropelvic junction obstruction (high ureteral insertion type). Dismembered pyeloplasty was extraper-itoneally performed. DIP showed the improvement of urine flow after the operation and pain attack disappear-ed. In Japan 137 cases of pelvic kidney were reported. In sixty eight cases nephrectomy was performed and only in 7 cases renal preservation surgery was carried out. We must avoid nephrectomy only because of pelvic kidney.