Abstract
Objective: To re-evaluate the usefulness of physical examination in ningen dock, we investigated whether a new disease can be detected by abdominal auscultation in addition to thoracic auscultation. Methods: Among the subjects who underwent a health checkup, we performed abdominal auscultation in those during hypertension treatment or those meeting the criteria for hypertension to detect renovascular hypertension. Results: We report a patient in whom characteristic abdominal vascular murmurs suggested renovascular hypertension. Patient: A male in his sixties. He had undergone hypertension treatment since 40 years of age. However, recently, blood pressure control was poor. The previous ningen dock in our hospital did not reveal any abnormalities. In this ningen dock, abdominal auscultation showed strong persistent vascular murmurs, with the strongest point in the left umbilical region, suggesting renovascular hypertension. Contrast-enhanced abdominal CT revealed marked stenosis at the origin of the left main renal artery and the presence of a left accessory renal artery. Angiography of the abdominal aorta and selective renal arteriography confirmed the two findings. We considered whether a stent should be inserted; however, there was no laterality in the findings on a segmental kidney function test using renal scintigraphy or renin activity on selective renal venous sampling. Therefore, drug therapy was indicated. Conclusion: Auscultation is important for detecting disorders with cardiovascular or pulmonary murmurs. We should recognize its role and target, and utilize this procedure in ningen dock.
