山本 徳則¹, 徳永 葉¹, 絹川 敬吾¹, 天野 正道¹, 田中 啓幹¹, 平井 紀之²

Tokunori YAMAMOTO¹, Yo TOKUNAGA¹, Keigo KINUKAWA¹, Masamichi AMANO¹, Hiroyoshi TANAKA¹, Noriyuki HIRAI²

¹川崎医科大学泌尿器科, ²川崎医科大学中央検査部

¹Department of Urology, Kawasaki Medical School, ²Hospital Laboratories, Kawasaki Medical School

キーワード : Left postrenal inferior vena cava, Pulse Doppler sonography, Macrohematuria, Renal vein

In order to elucidate unexplained hematuria, we measured the peak velocity of renal veins by Pulse Doppler sonography in a patient with the left postrenal vena cava. The peak velocity of renal veins was respectively 15 cm/sec, in the left site and 25 cm/sec, in the right. The data might indicate the congestion of the left renal vein. To disclose this phenomenon, we examined bilateral renal venous pressures selectively by means of the modified Seldinger's method. These pressures were 14.0 cm H₂O at the left renal vein and 7.8 cm H₂O at the right, which meant the congrestion of the left renal vein clearly.
The cause of this congrestion was speculated that the blood flow from the left renal vein into the vena cava was partially disturbed because of abdominal aorta and the abnormal angle between the left renal vein and the inferior vena cava. This investigation suggested that the congestion of the renal vein could be one of the main causes of unexplained hematuria.
Finally, we concluded that Pulse Doppler sonography was very useful for clinical examination of the renal blood flow.