高齢で発見された完全型膀胱外反症

A CASE OF COMPLETE EXSTROPHY OF THE BLADDER FOUND BY CHANCE AT THE AGE OF 64 YEARS

　64歳，女性。脳出血にて当院緊急入院となった際に発見された完全型膀胱外反症の1例を経験した。膀胱は下腹壁補強のため，筋層を残し粘膜のみ剥離し，露出した筋層を周囲の皮膚で覆った。尿路変更として回腸導管造設術を施行した。膀胱粘膜には悪性化の所見は認めなかった。本症例は発見されるまで重篤な合併症も発症せず未治療のまま64歳まで経過したきわめて稀なケースであり，しかも本邦報告例中最高齢の女性であった。

A 64-year-old female with complete bladder exstrophy was admitted in our hospital because of the cerebral hemorrhage. She had never recieved any medical treatment for 64 years, therefor bladder exstrophy was found by chance for the first time. She had several anomalies including, dysplasia of left upper urinary tract, diastasis of the symphysis pubis, uterus bicornis and uterine prolaps. In the operation, the formation of the ileal conduit was performed as the urinary diversion and the bladder mucosa was stripped off.