Digestive Surgery, "A. Gemelli" Hospital, Catholic University, Largo A. Gemelli, Rome, Italy.
Updates Surg. 2011 Mar;63(1):63-6. doi: 10.1007/s13304-010-0042-7. Epub 2011 Jan 13.
We present the case of a 73-year-old man affected by progressive and painful abdominal distension and paresthesia/hypoesthesia at the left leg. US and CT-scan revealed the presence in the left retroperitoneum of a large cystic mass without parietal thickening or enhancement after contrast injection. This mass disappeared after positioning a vesical Foley's catheter and a retrograde cystography confirmed the suspected diagnosis of a large bladder diverticulum due to a severe prostatic hypertrophy; the patient underwent an open diverticulectomy and endoscopic prostatic resection. Bladder diverticula can occasionally appear as complex pelvic masses not obviously connected to the bladder, eventually leading to diagnostic confusion; while small size diverticulum resolves with relief of bladder outlet obstruction, open or laparoscopic diverticulectomy is needed in large size diverticulum if symptomatic, even considering the possible tumor harboring.
我们报告了一例 73 岁男性患者，其逐渐出现腹部膨胀伴左侧腿部疼痛和感觉异常/感觉减退。超声和 CT 扫描显示左腹膜后腔有一个大的囊性肿块，肿块壁无增厚，对比剂注射后无强化。放置膀胱 Foley 导管后，肿块消失，逆行性膀胱造影证实了巨大膀胱憩室的可疑诊断，这是由于严重的前列腺增生引起的；患者随后接受了开放憩室切除术和内镜前列腺切除术。膀胱憩室偶尔会表现为与膀胱无明显联系的复杂盆腔肿块，最终导致诊断混淆；而小的憩室在解除膀胱出口梗阻后可自行消退，如果有症状，大的憩室则需要进行开放或腹腔镜憩室切除术，甚至需要考虑可能存在的肿瘤。
