クローン病に合併した膀胱腸瘻の1例

VESICOINTESTINAL FISTULA CAUSED BY CROHN'S DISEASE: REPORT OF A CASE

緒言

　クローン病は，主として若年者を侵す難治性疾患で，その合併症状の一つに内瘻形成があげられる。しかし，その多くは腸管と腸管における内瘻で，腸管と他臓器との間のものは少ない。なかでも膀胱腸瘻は稀で，本邦における報告は未だ12例にすぎない。最近21歳男性にみられたクローン病による膀胱腸瘻を経験したので報告する。

A 21-year-old man was admitted with gross hematuria and pain on urination. Cystoscopy revealed a mass in the right posterior wall and a fistula located in the center of the mass. An operation was performed under the diagnosis of vesico-intestinal fistula. It was found that terminal ileum formed a mass with an adhesion to the bladder wall and two stenotic sites were found in the oral side of the ileum. Resection of the ileum with the involved segment of the bladder was performed. The pathological diagnosis was Crohn's disease.