Kawamura Y J, Sugamata Y, Yoshino K, Abo Y, Nara S, Sumita T, Setoyama R, Kiribuchi Y, Kawano N
Department of Surgery, Sanraku Hospital, Tokyo, Japan.
J Gastroenterol. 1998 Dec;33(6):868-71. doi: 10.1007/s005350050190.
Appendico-vesical fistula is a rare condition. In total, 109 cases, most secondary to appendicitis, have been reported in the English-language literature. We report the first case, to our knowledge, of appendico-ileo-vesical fistula secondary to appendiceal diverticulitis. An enterovesical fistula was diagnosed by urine culture, cystoscopy, and computed tomography. The locations of enteric opening sites were demonstrated by barium enema and colonoscopy. Ileocecal resection and fistulectomy with primary reconstruction were performed. We believe that accurate pre- and intra-operative diagnosis is essential for cure. This case demonstrates the importance of barium enema and colonoscopic examinations in the diagnosis and treatment of complicated enterovesical fistula.
阑尾膀胱瘘是一种罕见的病症。英文文献中总共报道了109例病例，大多数继发于阑尾炎。据我们所知，我们报告了首例继发于阑尾憩室炎的阑尾回肠膀胱瘘病例。通过尿培养、膀胱镜检查和计算机断层扫描诊断出肠膀胱瘘。通过钡剂灌肠和结肠镜检查确定了肠道开口部位。进行了回盲部切除和瘘管切除术并一期重建。我们认为准确的术前和术中诊断对于治愈至关重要。该病例证明了钡剂灌肠和结肠镜检查在复杂肠膀胱瘘的诊断和治疗中的重要性。
