[Clinical experiences of endotoxin removal in urinary obstruction: report of two cases]

Clinical experiences of endotoxin removal using polymyxin B immobilized fiber column (PMX) in two septic shock patients are reported. Case 1: A 74-year-old man with bladder cancer received a total cystectomy and a ileal conduit 19 years before he was referred to our hospital with complaints of high fever and general fatigue. Physical examination and laboratory data revealed severe hypotension, and pyuria. Left hydronephrosis due to uretero-intestinal stenosis were observed on computed tompgraphy (CT). Under the diagnosis of septic shock, left nephrostomy were performed. Direct hemoperfusion using polymyxin B immobilized fiber column was carried out. Case 2: A 74-year-old woman referred to our hospital with complaints of abdominal pain. Physical examination and laboratory data revealed severe hypotension, and pyuria. Right hydronephrosis due to retroperitoneal fibrosis were observed on CT. Diagnoses of septic shock were made. After right nephrostomy were performed, direct hemoperfusion using polymyxinB immobilized fiber column was carried out.