穿孔により摘出を要した回腸利用新膀胱

Perforation of ileal neobladder：a case report

患者は50歳，男性。膀胱癌T3N0M0に対して膀胱全摘除術およびU字型回腸利用新膀胱造設術施行。外来通院中，右上腹部痛と嘔気・嘔吐を認め，当院に救急搬送された。黒色の嘔吐とCT上free airを認めたため，上部消化管穿孔を疑い，緊急手術を施行したところ新膀胱穿孔であった。新膀胱摘出と両側尿管皮膚瘻造設術を施行した。新膀胱穿孔について若干の文献的考察を加える。

A 50-year-old man with urothelial carcinoma of the bladder（clinical stage T3N0M0）underwent radical cystectomy and ileal neobladder construction（pathological stage T3bN0M0）. Four months later, he complained to right upper abdominal pain, and was admitted in an emergency. Abdominal CT scan showed free air below the diaphragm, and emergency laparotomy under a diagnosis of upper gastrointestinal tract perforation was performed. We actually found two small perforations in the neobladder, then we resected neobladder as much as possible and constructed ureterocutaneous fistula.