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膀胱异物取出术后的意外并发症:一例报告

An unexpected complication after removing bladder foreign body: a case report.

作者信息

Gong Pengfeng, Shen Jie

机构信息

Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.

出版信息

Front Surg. 2024 Aug 2;11:1405129. doi: 10.3389/fsurg.2024.1405129. eCollection 2024.

DOI:10.3389/fsurg.2024.1405129
PMID:39157291
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11327006/
Abstract

BACKGROUND

Bladder foreign bodies commonly arise as urgent issues in urology. These foreign bodies are typically extracted through cystoscopy or cystotomy. In general, these surgical approaches rarely lead to serious complications.

METHODS

A 34-year-old woman presented with a one-year history of frequent urination, urgency, and urodynia. Abdominal computed tomography (CT) scan revealed the presence of an intrauterine device (IUD) [a medium-sized (20 mm × 22 mm) circular IUD] near the posterior bladder wall. The object was successfully removed via cystoscopy. Two months later, the patient exhibited food residues in her urine. Enterography demonstrated a large amount of contrast agent had entered the bladder from the small intestine. We repaired the bladder with catheter for 2 weeks, removed the segment of small intestine with fistula, and anastomosed the intestine canal.

RESULTS

Post-operation urine tests yielded negative results, and the patient resumed a normal diet.

CONCLUSIONS

Evaluating the location between foreign body and bladder wall, which is based on medical history, CT scan, and cystoscopy examination, is essential for doctors before they remove the foreign body by cystoscopy or laparoscopy. It is necessary to check for leakage by applying radiopaque fluids under fluoroscopy after removing the foreign body, which migrates from other abdominal organs. If there is damage in the bladder or other organs, laparoscopic surgery or open surgery should be performed immediately.

摘要

背景

膀胱异物通常是泌尿外科的紧急问题。这些异物通常通过膀胱镜检查或膀胱切开术取出。一般来说,这些手术方法很少导致严重并发症。

方法

一名34岁女性有一年尿频、尿急和尿痛病史。腹部计算机断层扫描(CT)显示膀胱后壁附近有一个宫内节育器(IUD)[一个中等大小(20 mm×22 mm)的圆形IUD]。通过膀胱镜检查成功取出该异物。两个月后,患者尿液中出现食物残渣。小肠造影显示大量造影剂从小肠进入膀胱。我们用导管修复膀胱2周,切除有瘘管的小肠段,并吻合肠道。

结果

术后尿液检查结果为阴性,患者恢复正常饮食。

结论

在医生通过膀胱镜检查或腹腔镜取出异物之前,根据病史、CT扫描和膀胱镜检查评估异物与膀胱壁之间的位置至关重要。对于从其他腹部器官迁移而来的异物,取出后有必要在荧光透视下应用不透射线液体检查是否有渗漏。如果膀胱或其他器官有损伤,应立即进行腹腔镜手术或开放手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b9b/11327006/0f8750fdef72/fsurg-11-1405129-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b9b/11327006/0f8750fdef72/fsurg-11-1405129-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b9b/11327006/0f8750fdef72/fsurg-11-1405129-g001.jpg

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本文引用的文献

1
Laparoscopic removal of migratory intrauterine contraceptive device to the bladder : A Case report and literature review.腹腔镜下将迁移至膀胱的宫内节育器取出:一例病例报告及文献综述
Radiol Case Rep. 2024 Feb 3;19(4):1650-1653. doi: 10.1016/j.radcr.2024.01.047. eCollection 2024 Apr.
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Laparoscopic Repair of the Bladder: A Case of Intrauterine Device Migration to the Urinary Bladder.腹腔镜膀胱修补术:宫内节育器迁移至膀胱1例。
J Minim Invasive Gynecol. 2021 Aug;28(8):1433-1435. doi: 10.1016/j.jmig.2021.01.023. Epub 2021 Feb 4.
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Removal of foreign bodies embedded in the urinary bladder wall by a combination of laparoscopy and carbon dioxide cystoscopic assistance: Case report and literature review.
腹腔镜联合二氧化碳膀胱镜协助取出嵌顿于膀胱壁内的异物:病例报告并文献复习。
Investig Clin Urol. 2016 Nov;57(6):449-452. doi: 10.4111/icu.2016.57.6.449. Epub 2016 Nov 1.
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Foreign Bodies in the Urinary Bladder and Their Management: A Single-Centre Experience From North India.膀胱异物及其处理:来自印度北部的单中心经验
Int Neurourol J. 2016 Sep;20(3):260-269. doi: 10.5213/inj.1632524.262. Epub 2016 Sep 23.
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Fish bone migration to the urinary bladder after rectosigmoid colon perforation.乙状结肠直肠穿孔后鱼骨移行至膀胱。
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