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[克罗恩病并发膀胱直肠瘘:两例报告]

[Enterovesical fistula complicating Crohn's disease: report of two cases].

作者信息

Kawakami S, Yamada T, Watanabe T, Negishi T

机构信息

Department of Urology, Kasukabe Municipal Hospital.

出版信息

Hinyokika Kiyo. 1992 Jan;38(1):71-5.

PMID:1546574
Abstract

Two female patients with enterovesical fistula complicating Crohn's disease are presented. Case 1: A 40-year-old woman having a 10-year history of diarrhea presented with vesical irritability of a three months duration. Administration of antibiotics did not relieve her of the symptoms and then pneumaturia appeared. Cystoscopic examination revealed fistulous opening. Barium enema study depicted rectovesical fistula. After partial cystectomy and temporary colostomy, ileocecal lesion was shown by contrast study and resection of ileocecal segment was performed seven months later. Case 2: A 33-year-old woman presented with vesical irritability of 7 years duration and pneumaturia and fecaluria of 4 years duration. Cystoscopic examination revealed localized bullous edema but no apparent fistula. Cystography, as well as contrast studies demonstrated ileo-vesical, ileo-ascending colonic and ileo-sigmoidal fistulas. One-stage resection of diseased intestine and partial cystectomy were performed. In both cases, pathological diagnoses of Crohn's disease was made, and postoperative course was uneventful for over 10 months. Thirty eight cases of enterovesical fistula complicating Crohn's disease are reviewed.

摘要

本文介绍了两名患有克罗恩病并发肠膀胱瘘的女性患者。病例1:一名40岁女性,有10年腹泻病史,出现膀胱刺激症状3个月。使用抗生素未能缓解症状,随后出现气尿。膀胱镜检查发现瘘口。钡灌肠检查显示直肠膀胱瘘。在部分膀胱切除和临时结肠造口术后,造影检查显示回盲部病变,7个月后进行了回盲部切除。病例2:一名33岁女性,有7年膀胱刺激症状,4年气尿和粪尿病史。膀胱镜检查发现局限性大疱性水肿,但无明显瘘口。膀胱造影以及造影检查显示回肠膀胱瘘、回肠升结肠瘘和回肠乙状结肠瘘。进行了一期病变肠段切除和部分膀胱切除。在这两个病例中,均作出了克罗恩病的病理诊断,术后10多个月病情平稳。本文还回顾了38例克罗恩病并发肠膀胱瘘的病例。

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