S状結腸癌による膀胱S状結腸瘻の1例—尿管カテーテルによる瘻孔造影

A CASE OF SIGMOIDOVESICAL FISTULA CAUSED BY SIGMOID COLON CANCER: SUCCESSFUL FISTULOGRAPHY BY A URETERAL CATHETER

緒言

　膀胱腸瘻の原因として，炎症性，腫瘍性，外傷性，先天性の4種が主に知られている^1〜3）。その一型として膀胱S状結腸瘻があり，この原因疾患としては，S状結腸憩室炎と腫瘍などが挙げられる^1〜3）。S状結腸憩室炎による膀胱S状結腸瘻は，欧米に比べて本邦では比較的稀で^4），腫瘍性の膀胱S状結腸瘻が近年増加しつつある^5）。

　最近，われわれは原発部位診断が問題となつたS状結腸癌による膀胱S状結腸瘻の1例を経験したので報告する。

A 70-year-old male was admitted to our clinic on ,June 29, 1981 complaining of urinary discharge of small blood clots. He had symptoms of typical cystitis and underwent cystoscopy which revealed a thumb-tip sized non-papillary sessile tumor covered with white necrotic tissue in the left posterolateral wall near the bladder dome. The tumor was proved to be an adenocarcinoma by TUR biopsy. A combined chemotherapy and irradiation were instituted under a tentative diagnosis of bladder cancer. On the 4th week of chemotherapy and after completion of 2,400 rads irradiation, fecauria was noted.