Tanaka K, Akimoto S, Kozuma T, Sato O, Miyata T, Oshima T, Takagi A, Tada Y, Maruyama Y, Wada T
Nihon Geka Gakkai Zasshi. 1984 Aug;85(8):849-54.
A case of renovascular hypertension in a patient with a congenitally solitary kidney associated with retrocaval ureter is reported. Aortorenal bypass with autogenous saphenous vein graft and concomitant mobilization of the ureter by division and reanastomosis of the inferior vena cava were performed. Pathogenesis of the stenotic lesion of the renal artery was fibromuscular dysplasia. Postoperative improvement of hypertension was not so good as expected. Soon after administration of nifedipine (20mg/day) was started, blood pressure decreased down to 130/80mmHg and had been well controlled. Problems regarding renovascular hypertension with a solitary kidney and surgical treatment of retrocaval ureter are discussed.
报告了一例先天性孤立肾合并腔静脉后输尿管患者的肾血管性高血压病例。采用自体大隐静脉移植行主动脉-肾动脉旁路移植术,并通过下腔静脉离断和再吻合同时游离输尿管。肾动脉狭窄病变的发病机制为纤维肌发育不良。术后高血压的改善不如预期。开始服用硝苯地平(20mg/天)后不久,血压降至130/80mmHg并得到良好控制。讨论了孤立肾肾血管性高血压及腔静脉后输尿管的外科治疗问题。