Ueda T, Miura N, Suzuki K, Suzuki F, Inomiya H, Kotake T, Nishikawa Y, Yamaguchi K, Ito H
Department of Urology, Teikyo University School of Medicine, Ichihara Hospital.
Hinyokika Kiyo. 1992 May;38(5):569-72.
A 66-year-old man with the chief complaint of oliguria had been referred to our hospital under the diagnosis of bilateral hydronephrosis and abdominal aortic aneurysm by his family doctor. CT scan and digital subtraction angiography demonstrated an abdominal aortic aneurysm continuing to bilateral internal iliac arteries. The degree of right hydronephrosis was less advanced compared to the left side. Right percutaneous nephrostomy was performed because the retrograde stenting was unsuccessful. After the renal function improved, an operation for the aneurysm was undertaken in the surgical department. Although bilateral ureterolysis was possible, the resection of the aneurysm could not be done. After clamping the nephrostomy catheter, drainage of urine into the ureter was not seen one month after the operation. A double-J ureteral stent was inserted by the antegrade approach and the nephrostomy tube was removed. By exchanging the stent every 3 months, the renal function has been stable and the size of the aneurysm unchanged during the 25 months after the surgery.
一名66岁男性因少尿为主诉被其家庭医生转诊至我院,诊断为双侧肾积水和腹主动脉瘤。CT扫描和数字减影血管造影显示腹主动脉瘤延续至双侧髂内动脉。右侧肾积水程度较左侧轻。由于逆行支架置入失败,遂行右侧经皮肾造瘘术。肾功能改善后,外科对动脉瘤进行了手术。虽然可行双侧输尿管松解术,但无法切除动脉瘤。术后夹闭肾造瘘导管后,术后1个月未见尿液排入输尿管。通过顺行途径插入双J输尿管支架并拔除肾造瘘管。每3个月更换一次支架,术后25个月肾功能一直稳定,动脉瘤大小未变。