難治性の下痢症状を呈したコックポウチ—回腸瘻

A CASE REPORT OF ENTERO-POUCH FISTULA: PRESENTING SEVERE DIARRHEA 2-YEAR AFTER THE URINARY DIVERSION BY THE KOCK POUCH

　53歳，女性。浸潤性膀胱腫瘍にて膀胱全摘，コックポウチ造設。直後より腎盂腎炎を繰り返し，2年後より難治性の下痢が出現した。カテーテル留置による下痢の消失と骨シンチグラムによる腸管を示唆するアイソトープの集積よりコックポウチ—腸管瘻を疑い精査を施行。ポウチ前壁と回腸の瘻孔が判明し，開腹により修復を行った。

A 53-year-old woman was hospitalized with the diagnosis of acute pyelonephritis. Total cystectomy and Kock urinary diversion were performed for her bladder cancer 4 years previously. She suffered recurrent pyelonephritis and severe diarrhea. At the latest admission, her diarrhea was proved to occur due to entero -pouch fistula. The fistula was repaired by re-exploration.