放射線治療後22年を経過して発症した再発性膀胱自然破裂の1例

Abstract

68歳女.放射線治療後22年を経過して発症した再発性膀胱自然破裂例を報告した.初発時に血中Cr, BUNの上昇を認めた.再発時には尿路感染を認めたが, 全身状態が良好で, 炎症反応も軽度であったため, 保存的治療を選択した.再発予防としては, 併発する慢性膀胱炎による膀胱壁の脆弱化が再発の一因となりうることから, 抗菌剤少量長期投与による尿路感染の予防が重要と考える

The patient, a 68-year-old woman, had undergone radical hysterectomy and post-operative radiotherapy for uterine cancer in 1974. She was admitted to our hospital complaining of abdominal pain in February, 1996. Contrast-enhanced computed tomographic scan and cystography showed leakage of contrast medium around the bladder. We diagnosed her with spontaneous vesical rupture, and performed conservative therapy. Two months later, she was re-admitted with recurrent vesical rupture. We again performed conservative therapy. We consider that conservative therapy can be indicated for spontaneous vesical rupture with good general condition and no severe urinary tract infection.