診断に苦慮したS状結腸癌による結腸膀胱瘻の1例

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  • A CASE OF SIGMOID COLON CANCER FORMING A COLOVESICAL FISTULA-A CASE REPORT-

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An 82-year-old man was admitted to our hospital complaining of diarrhea and severe abdominal pain. During the therapy, fecaluria and the symptoms of cystitis were noted. A colonovesical fistula was suspected, though barium enema and cystography could not detect it. Colonofiberscopy could not be performed because of adhesion of the sigmoid colon due to the fistula. Abdominal CT showed the thickness of the wall of the sigmoid colon and inflammation of surrounding tissues. MRI failed to detect the fistula. With no improvement of the symptoms with conservative therapy, an operation was performed. The ulcerative lesion of the sigmoid colon was found to penetrate the bladder, and sigmoidectomy with palliative colostomy was performed because of his poor general condition. Pathology revealed it to be an adenocarcinoma of the sigmoid colon.

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