Sigel A, Bötticher R, Supala K
Chirurg. 1977 Apr;48(4):262-6.
The three most common inflammatory diseases of the bowel, colonic diverticulitis, regional enteritis and ulcerative colitis, involve the bladder or ureter in the advanced stage in about 10%. The colovesical fistula is found more frequently with diverticulitis and less often with regional enteritis, which penetrates predominantly from the ileum into the bladder. On the other hand, if an ureteric stenosis develops, it will be caused on the right side mainly by regional enteritis and on the other side by ulcerative colitis. The vesicointestinal fistulae will close without sequelae after resection of the involved bowel segment. However, the ureteric stenosis will often be followed by nephrectomy despite bowel resection and ureterolysis, if the operation is not undertaken early enough. Frequent rechecks with infusion urography should help to prevent this. Nephrolithiasis, amyloidosis, and a contracted bladder are futher, yet less common complications of chronic inflammatory disease of the bowel.
三种最常见的肠道炎症性疾病,即结肠憩室炎、局限性肠炎和溃疡性结肠炎,在晚期约有10%会累及膀胱或输尿管。结肠膀胱瘘在憩室炎中更常见,在局限性肠炎中较少见,后者主要从回肠穿入膀胱。另一方面,如果发生输尿管狭窄,右侧主要由局限性肠炎引起,另一侧由溃疡性结肠炎引起。切除受累肠段后,膀胱肠道瘘可自愈且无后遗症。然而,如果手术不够及时,尽管进行了肠切除和输尿管松解术,输尿管狭窄后仍常需进行肾切除术。频繁进行静脉肾盂造影复查有助于预防这种情况。肾结石、淀粉样变性和膀胱挛缩是肠道慢性炎症性疾病较少见的进一步并发症。