腸膀胱瘻の6例 SIX CASES OF VESICOENTERIC FISTULA

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過去13年間に,腸膀胱瘻6例を経験したので報告する.年齢は平均62.7歳で,男性4例,女性2例であった.主訴は糞尿5例,血尿1例で,病悩期間は2カ月以内であった.術前検査では,注腸造影検査にて2例で腸膀胱瘻が造影された.また膀胱鏡検査では全例で糞便を,さらに1例では瘻孔からの排便を認めた.腹部CT検査では,全例で膀胱内に空気を認めた.以上の諸検査から,全例で腸膀胱瘻と術前診断した.またその原疾患として,直腸癌3例, S状結腸憩室炎2例,放射線治療1例と診断した.手術は,直腸癌症例では骨盤内臓器全摘除術2例および膀胱部分切除を伴う直腸前方切除術1例を行った. S状結腸憩室炎症例では膀胱部分切除を伴うS状結腸切除術を行った.放射線治療症例では著明な骨盤内癒着を認めたため,単に人工肛門を造設した.人工肛門を造設した例を除く他の5例では,腸膀胱瘻は治癒した.

Six cases of vesicoenteric fistula which had been operated in a recent 13-year period are reported. Their mean age was 62.7 years, and male-to-female ratio was 4:2. Five patients had fecaluria, and another patient had hematuria. Barium enemas revealed vesicoenteric fistula in two patients. All patients underwent cystoscopy and fecaluria were see. However, feces were seen to enter the bladder from a fistula in only one patient. Computed tomography showed air in the bladder in all patients. From these studies, the diagnosis of vesicoenteric fistula was made in all patients. Their primary diseases causing vesicoenteric fistula were rectal cancer in three patients, sigmoid diverticulitis in two patients and radiotherapy in one patient. Of three patients with rectal cancer, two patients underwent total pelvic exenteration, and the remaining patient underwent proctosigmoidectomy with partial cystectomy. Two patients with diverticulitis underwent sigmoidectomy with partial cystectomy. The patient with rectovesical fistula secondary to radiotherapy was treated by sigmoid colostomy because reversal was difficult due to pelvic adhesion. All fistulas successfully healed except one who had a sigmoid colostomy.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 59(11), 2917-2920, 1998-11-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008437605
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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