直腸肛門奇形に合併した泌尿器疾患の検討

Abstract

8例の直腸肛門奇形症例を対象とした.年齢は1歳～14歳に分布し, 全例男児であった.直腸肛門奇形の病型は, 低位型1例を除くすべての症例が高位型であった.これらの症例の泌尿器科的合併症は, 水腎症, VURなどの尿路異常から停留精巣, 陰茎前位陰嚢などの性器異常まで多岐にわたっており, しかもいくつかの異常が重なっている症例が多かった

Anorectal malformations involve genitourinary anomalies frequently. In this study, the treatment and prognosis for genitourinary anomalies in 8 patients with anorectal malformations were discussed. All patients were men (range 1 to 14 years). Seven of them showed high types of anorectal malformations and one low type. Five patients were managed surgically. Among them, 3 were treated successfully, but the outcome was not good for 2 patients. These 2 patients have been followed up under careful observation. The treatment could not be performed on one patient with poor bowel function. In this series, successful results were obtained on patients with a low degree of anomalies. However, there were hazard problems in patients with a high degree of anomalies. Neurogenic bladder was included among these problems. It is difficult to diagnose and treat genitourinary anomalies on a newborn baby with anorectal malformations, when these anomalies might be complicated with other severe anomalies such as congenital heart diseases. In such cases, genitourinary anomalies should be treated as conservatively as possible until the patient's condition has improved.