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人造肛门术后发生乙状结肠膀胱瘘者极罕见,作者进行首例报告,患者女性,75岁。曾于1982年4月因直肠癌行Miles手术,用乙状结肠造肛门时未见异常。术后盆腔感染,保守治疗痊愈。1988年10月下腹痛伴腹泻,详细检查未见异常。1991年3月上旬始发热腹泻,3月18日出现尿粪收入院。查血常规及生化均正常。尿常规见大量红细胞和白细胞,尿培养有大肠杆菌。膀胱镜检查见膀胱顶部显著红肿,未见瘘孔。静脉肾盂造影上尿路正常,膀胱有缺损阴影,考虑是粪便。膀胱造影时乙状结肠显影,但无明显瘘孔。从人工肛门行灌肠造影确诊乙状结肠膀胱瘘。1991年4月11日手术,距人工肛门约10cm处乙状结肠与膀胱顶紧密粘连,部分回肠亦粘连,分离粘连
The authors report the first case of a sigmoid colon blastogenesis after a man-made anus surgery in women, 75 years of age. Had in April 1982 Miles surgery for rectal cancer, anus with the sigmoid colon anomalies. Postoperative pelvic infection, conservative treatment healed. October 1988 with abdominal pain with diarrhea, detailed examination showed no abnormalities. Early in March 1991 fever diarrhea, urine fecal admission March 18 hospital. Check blood and biochemistry are normal. See a large number of urine routine red blood cells and white blood cells, urine culture with E. coli. Cystoscopy showed significant swelling at the top of the bladder, no fistula hole. Intravenous pyelography on the normal urinary tract, bladder defect shadow, consider the stool. Bladder sigmoid colon imaging, but no obvious fistula. From artificial anorectal angiography confirmed sigmoid colon fistula. April 11, 1991 surgery, about 10cm from the artificial anorectal sigmoid colon and bladder top close adhesion, some ileum also adhesion, separation of adhesions