遺残ガーゼの膀胱内への迷入

INTRAVESICAL MIGRATION OF RETAINED SURGICAL SPONGE: A CASE REPORT

　68歳，女性。主訴は肉眼的血尿。膀胱鏡検査で膀胱内に遊離ガーゼ塊がみられた。ガーゼは経尿道的に摘出した。この患者は17か月前に右鼠径ヘルニア根治術を受けており，その12か月後のCTで膀胱外の骨盤内腫瘤を指摘された。今回のCTでは膀胱外の腫瘤は消失し，代わりに膀胱内に腫瘤がみられた。膀胱手術の既往のないことより，この腫瘤は鼠径ヘルニア根治術時の遺残ガーゼであり，膀胱外から膀胱内に迷入したものと思われた。

A 68-year-old woman was referred to us because of gross hematuria and micturitional pain. The surgical sponge was detected in the bladder by cystoscopy and removed transurethrally. Seventeen months before this episode, she underwent right inguinal hernioplasty and after 12 months of the operation she was diagnosed as having extravesical tumor by CTscan. CTscan in our hospital revealed intravesical tumor but extravesical tumor was not detected. Because of no past history of bladder operations we suspected the surgical sponge retained on inguinal hernioplasty eroded through the wall of the bladder into its lumen.