Maeda Takahiro, Uchida Yasumitsu, Oyamada Kazuhiro, Nakajima Fumio
Department of Urology, Keiyu Hospital, Yokohama, Japan.
Intern Med. 2010;49(17):1891-4. doi: 10.2169/internalmedicine.49.3748. Epub 2010 Sep 1.
We report a rare case of thrombosis in the inferior vena cava (IVC) due to enlarged cysts in autosomal dominant polycystic kidney disease. A 71-year-old woman visited our hospital with a complaint of rapid left lower extremity swelling. Computed tomography (CT) revealed massive thrombosis from the IVC to the bilateral common iliac vein. The extrinsic mechanical stress of renal cysts to the IVC seemed to have induced thrombosis in the vein that resulted in the cause of severe edema in the left lower extremity. Her renal cysts were percutaneously punctured for the relief of compression and she received injection of 99.5% ethanol for prevention against reaccumulation of cyst fluid after IVC filter had been positioned. The edema of her left lower extremity improved temporarily, however, follow-up CT two months after cyst puncture showed reaccumulation of the fluid. Therefore, excision of the responsible cyst wall by open surgery was carried out.
我们报告了一例因常染色体显性多囊肾病中囊肿增大导致下腔静脉（IVC）血栓形成的罕见病例。一名71岁女性因左下肢迅速肿胀前来我院就诊。计算机断层扫描（CT）显示从下腔静脉到双侧髂总静脉有大量血栓形成。肾囊肿对下腔静脉的外部机械压力似乎诱发了静脉血栓形成，导致左下肢严重水肿。经皮穿刺她的肾囊肿以缓解压迫，并在放置下腔静脉滤器后注射99.5%乙醇以防止囊肿液再次积聚。她左下肢的水肿暂时有所改善，然而，囊肿穿刺两个月后的随访CT显示液体再次积聚。因此，通过开放手术切除了相关的囊肿壁。
