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タイトル: | 直腸切断術後にみられた遅発性尿管瘻の2例 |
その他のタイトル: | Two cases of delayed ureteral fistulas following rectal amputation |
著者: | 井上, 幸治 西村, 一男 五十川, 義晃 大森, 孝平 |
著者名の別形: | INOUE, Koji NISHIMURA, Kazuo ISOGAWA, Yoshiaki OHMORI, Kouhei |
キーワード: | Ureteral fistula Rectal amputation |
発行日: | Apr-1998 |
出版者: | 泌尿器科紀要刊行会 |
誌名: | 泌尿器科紀要 |
巻: | 44 |
号: | 4 |
開始ページ: | 285 |
終了ページ: | 288 |
抄録: | 1)直腸切断術1ヵ月目にみられた尿管瘻の2例を経験した. 2)症例1は尿管ステント留置のみで治癒し, 症例2は腎瘻造設の後, 膀胱尿管新吻合術により治癒した. 3)尿管瘻に対する治療はまず尿管ステント留置を試みるべきである We report two rare cases of delayed ureteral fistulas which occurred one month following rectal amputation. Case 1 was a 52-year-old male who underwent abdominal perineal resection of the rectum. One month after surgery, the patient had a paralytic ileus. Computed tomographic (CT) scan and drip infusion pyelography showed left ureteral fistula and a large pelvic urinoma. Because retrograde placement of a double-J stent was unsuccessful, antegrade placement of the double-J stent was performed. The fistula and urinoma healed soon after the placement of the double J stent. Case 2 was a 43-year-old male who underwent abdominal sacral resection of the rectum. One month after surgery, a large amount of urine began to drain from the perineal wound. CT scan and retrograde pyelography showed a right ureteral fistula and a large pelvic urinoma. There had been temporary improvement in the discharge without the treatment of the ureteral fistula, only for it to return more profusely. Because placement of a double-J stent was unsuccessful, right percutaneous nephrostomy was performed, after which, a right ureterocysto-neostomy (Boari flap method) was performed. We advocate the initial use of the double-J stent or percutaneous nephrostomy in ureteral fistula. This approach is simple and may cure the fistula. If unsuccessful, it will not hinder subsequent open surgery. |
URI: | http://hdl.handle.net/2433/116158 |
PubMed ID: | 9617627 |
出現コレクション: | Vol.44 No.4 |
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