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| 염증성 복부대동맥류에 의한 요관폐쇄 |
| 이정상 , 양원석 , 김윤구 , 한진석 , 김성권 |
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| Abstract |
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Amominal aortic aneurysms are rare causes of ureteral obstruction. We report three cases of inflamma- tory aortic aneurysm producing hydronephrosis, include- ing one case with acute renal failure. The three patients were all males and ages over 50 years. The diagnosis was established by computed tomo- graphy (CT) in all three cases, when mural thrombosis, enhancing periaortic soft tissue mantle with relative sparing of the posterior wall and/or wall calcification are present. Magnetic resonance (MR) studies in two cases (case 1, case 3) displayed a periaortie soft tissue mantle of low signal intensity (SI) on Tl-weighted images (WI) and of heterogenous intermediate SI (case 1) and low SI (case 3), respectively on T2-WI. Follow up MR studies after 2 years (case 1) showed decreased SI of periaortic mantle on T2-WI. Two patients (case 2, 3) underwent aneurysmectomy with ureteolysis and aneurysmectomy only, respectively. One patient (case 3) expired due to post-operative com- plications. In conclusion, inflammatory aortic aneurysm should be considered as the cause of ureteric obstruction espe- cially in old male patients. A CT scan with contrast may demonstrate typical findings and excretory urogram should be performed when asymptomatic aortic aneur- ysm is evaluated with angiography. |
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