Koizumi Koji, Kamigaito Takayuki, Maruyama Atsushi, Nakayama Tsuyoshi
The Department of Urology, Ina Central Hospital.
The Department of Gastroenterology, Ina Central Hospital.
Hinyokika Kiyo. 2015 Jan;61(1):19-21.
A 68-year-old man treated for type C liver cirrhosis was referred to our hospital for evaluation of a bladder tumor. The patient underwent transurethral resection of bladder tumor. The histopathological diagnosis was urothelial cancer (G2>G3, T2) and he underwent radical cystectomy with ileal conduit urinary diversion. Starting 3 months postoperatively, he experienced bleeding from the mucosa of the ileal conduit. Computed tomography showed vascular dilatation around the ileal conduit. This was considered to be attributable to portal hypertension resulting from liver cirrhosis. Conservative therapy failed to achieve hemostasis. The patient was not considered to have indications for a transjugular intrahepatic portosystemic shunt (TIPS). He died from bleeding 22 months after radical cystectomy.
一名68岁接受C型肝硬化治疗的男性因膀胱肿瘤评估被转诊至我院。患者接受了经尿道膀胱肿瘤切除术。组织病理学诊断为尿路上皮癌（G2>G3，T2），随后他接受了根治性膀胱切除术及回肠代膀胱术。术后3个月开始，他出现回肠代膀胱黏膜出血。计算机断层扫描显示回肠代膀胱周围血管扩张。这被认为是由肝硬化导致的门静脉高压所致。保守治疗未能止血。该患者不被认为有经颈静脉肝内门体分流术（TIPS）的指征。他在根治性膀胱切除术后22个月死于出血。
