Jimie Joachim, Siraj Mamoon, Lyttle Margaret, Alaaraj Hazem
Department of Urology, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, Cheshire, UK
Department of Urology, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, Cheshire, UK.
BMJ Case Rep. 2020 Mar 31;13(3):e233123. doi: 10.1136/bcr-2019-233123.
A 65-year-old comorbid female patient presented to our urology department with a history of multiple interventions to treat severe overactive bladder symptoms. She had a history of clam ileocystoplasty, which was then converted to an ileal conduit due to failure to resolve her symptoms. She subsequently developed multiple complications, most significantly ureteroileal stenosis, managed with bilateral ureteric stents. She later decided on bilateral nephrostomies and subsequent antegrade stent insertion. At follow-up, the proximal end of the left stent remained within the kidney and the distal end was free within the abdominal cavity. There was further migration of the stent in its entirety into the lumen of the terminal ileum on subsequent imaging. She denied any significant gastrointestinal symptoms, signs or peritonitis. Consideration was made for the endoscopic removal of the stent by the gastrointestinal team; however, the patient refused any further procedures preferring to be monitored.
一名65岁的患有多种疾病的女性患者因严重膀胱过度活动症症状接受过多次治疗，前来我院泌尿外科就诊。她曾接受过回肠膀胱扩大术，但由于症状未缓解，后来改为回肠代膀胱术。她随后出现了多种并发症，最严重的是输尿管回肠狭窄，通过双侧输尿管支架进行治疗。她后来决定进行双侧肾造瘘术及随后的顺行支架置入术。在随访中，左支架近端仍留在肾脏内，远端在腹腔内自由活动。在随后的影像学检查中，支架整体进一步移入末段回肠腔内。她否认有任何明显的胃肠道症状、体征或腹膜炎。胃肠病学团队考虑通过内镜取出支架；然而，患者拒绝任何进一步的手术，更愿意接受监测。
