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74歳,男性。浸潤性膀胱癌のため根治的膀胱全摘出術および回腸導管造設術を行った8カ月後に導管口からの糞尿が出現した。IVP,逆行性導管造影などにて,右水腎症,回腸導管・回腸痩と診断。開腹術を行ったところ,骨盤膣内の腫瘤に右尿管,回腸導管,終末回腸が巻き込まれていた。腫瘤の生検は低分化型腺癌であった。巻き込まれた回腸を遊離して盲ループとし,回腸の連続性を再建した。右尿管は導管に再吻合した。
A 74-year-old man who had undergone radical cystectomy and ileal conduit construction for bladder cancer 8 months before, developed fecaluria from the ileal conduit. Retrograde loopogram and upper gastrointestinal series revealed a fistula between the conduit and ileum. Laparotomy dis-closed that the right ureter, conduit and terminal ileum were involved in a pelvic mass. Biopsy of the mass showed poorly differentiated adenocarcinoma. The involved portion of the ileum was isolated and the ileal continuity was reconstructed.
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