■症例報告
急性腹症の発症を契機に早期診断された交差血管による間欠性水腎症の1例
石井 龍1, 柳原 剛1, 高橋 翼2, 右田 真1, 伊藤 保彦1
1日本医科大学付属病院小児科
2日本医科大学武蔵小杉病院小児外科
A Case of Intermittent Hydronephrosis due to An Aberrant Vessel Diagnosed Early after the Onset of Acute Abdomen
Ryu Ishii1, Takeshi Yanagihara1, Tsubasa Takahashi2, Makoto Migita1 and Yasuhiko Itoh1
1)Department of Pediatrics, Nippon Medical School
2)Department of Pediatric Surgery, Nippon Medical School, Musashi Kosugi Hospital
A healthy 8-year-old boy was admitted to our hospital with a complaint of abdominal pain. Vital signs were normal, as were blood-tests findings. Urinalysis revealed a significantly elevated level of urinary occult blood, and left renal pelvic dilatation (grade 3 according to the Society for Fetal Urology classification) was detected on abdominal ultrasound. Abdominal contrast-enhanced computed tomography also showed left renal pelvic dilatation, enlargement of the left kidney along with an extrarenal pelvis, and a bright cord-like substance in the left ureter. On the basis of these findings, we diagnosed transient hydronephrosis due to an aberrant vessel in the ureteropelvic junction. The patient's symptoms improved with conservative treatment. Two months later, renal dynamic scintigraphy revealed delayed excretion in the left kidney. Elective left pyeloplasty was performed 8 months after diagnosis, and there has been no recurrence of abdominal pain since. In cases of acute abdomen, a urine test should be performed, and transient hydronephrosis should be considered in the differential diagnosis.
日医大医会誌 2024; 20(2), 126-129
Key words
hydronephrosis, acute abdomen, aberrant vessel, ureteropelvic junction
Correspondence to
Ryu Ishii, Department of Pediatrics, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：s13-008ir@nms.ac.jp
受付：2024年1月11日 受理：2024年3月19日 |
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