Shi Fan, Wang Tao, Wang Jiquan, Hui Beina, Chai Yanlan, Wang Juan, Liu Zi
Department of Radiation Oncology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
Oncol Lett. 2016 Sep;12(3):2008-2010. doi: 10.3892/ol.2016.4820. Epub 2016 Jul 7.
The occurrence of a peritoneal bladder fistula as a result of radiation cystitis following radiotherapy for cervical cancer is extremely rare and, to the best of our knowledge, has not been reported previously. The present study reports the case of a 50-year-old woman who was diagnosed with cervical cancer 20 years previously and was treated with radiotherapy. The patient was diagnosed with radiation cystitis 10 years ago, which was treated with Chinese medicine, and began experiencing sudden abdominal pain and bowel difficulties following urination 3 years ago. B-ultrasound examination at The People's Hospital of Tongchuan (Tongchuan, China) detected the presence of abdominal pelvic fluid. Following antibiotic (levofloxacin for 5 days) and ascites extraction treatment, symptoms were relieved without recurrence. However, 5 days prior to admission to the First Affiliated Hospital of Xi'an Jiatong University (Xi'an, China) on June 25, 2014, the patient experienced difficulty when urinating, abdominal pain and bloating, but did not experience frequent urination, hematuria or fever. Cystoscopic examination revealed a visible fistula on the bladder wall measuring 1×1 cm in diameter. Cytoscopic examination 1 month after catheterization and ascites extraction revealed no evidence of the fistula. The patient was followed up every 3 months for a year and a half, and is currently alive and well. In conclusion, the occurrence of peritoneal bladder fistula following radiation therapy is rare and cystoscopy is the preferred method of examination and diagnosis. Early detection and treatment may significantly improve the prognosis of patients.
宫颈癌放疗后因放射性膀胱炎导致腹膜膀胱瘘的情况极为罕见，据我们所知，此前尚未有相关报道。本研究报告了一例50岁女性病例，该患者20年前被诊断为宫颈癌并接受了放疗。患者10年前被诊断为放射性膀胱炎，接受了中医治疗，3年前开始在排尿后出现突发腹痛和排便困难。铜川市人民医院（中国铜川）的B超检查发现腹腔盆腔有积液。经过抗生素治疗（左氧氟沙星5天）和抽取腹水治疗后，症状缓解且未复发。然而，在2014年6月25日入住西安交通大学第一附属医院（中国西安）的5天前，患者出现排尿困难、腹痛和腹胀，但无尿频、血尿或发热症状。膀胱镜检查发现膀胱壁上有一个直径为1×1厘米的可见瘘管。插管和抽取腹水1个月后的膀胱镜检查未发现瘘管迹象。对该患者进行了一年半的每3个月一次的随访，患者目前健在。总之，放疗后腹膜膀胱瘘的发生较为罕见，膀胱镜检查是首选的检查和诊断方法。早期发现和治疗可显著改善患者的预后。
