経尿道的に迷入し腹腔鏡下手術で摘出した腹腔内異物（体温計）の1例

Laparoscopic removal of an intraperitoneal foreign body introduced through the urethra : a case report

◆要旨：患者は55歳，女性．肝機能障害の精査目的で紹介され受診した．腹部単純X線写真で水銀体温計が認められ，無症状であったが，消化管異物の疑いで緊急入院となった．腹部CT検査，大腸内視鏡および小腸造影では，腸管内に体温計を認めなかった．数年前，性行為中に尿道から体温計を挿入されたが，回収できず放置しており，経尿道的に発生した腹腔内異物と診断し，腹腔鏡下手術で異物摘出を行った．体温計は大網と連続する線維性の被膜を有し，この被膜内で破損していた．腹腔内異物の多くは，手術時のガーゼなどの遺残や，針や魚骨などの誤飲で発生したものである．経尿道的に発生した腹腔内異物の報告は少なく，調べえた限り自験例を含めて14例であった．

　A 55-year-old woman was referred to our department for further evaluation of liver dysfunction. An abdominal X-ray showed a mercury-in-glass thermometer. She was asymptomatic but was emergently admitted with the suspicion of gastrointestinal foreign body. Abdominal CT, colonoscopy, and a small bowel series revealed no thermometer in the bowel. The patient's partner had inserted a thermometer into her urethra during sex several years ago. The thermometer could not be retrieved and thus was left there. These findings, along with the patient's history, led to the diagnosis of intraperitoneal foreign body introduced through the urethra. The foreign body was removed by laparoscopic surgery. The thermometer was found to be broken and encapsulated in connective tissue. Intraperitoneal foreign bodies commonly include surgical material, such as gauze left after surgery, and accidentally swallowed needles and fish bones. Reports of intraperitoneal foreign bodies introduced through the urethra are rare, and literature review revealed only 14 reported cases.