尿管回腸導管による絞扼性腸閉塞の1例

Retro-ureteral small bowel herniation after total pelvic exenteration：a case report

今回我々は，骨盤内臓器全摘出術後に，再建尿管によって小腸の内ヘルニアをきたし，腸閉塞および水腎症を呈した症例を経験した。

We report the case of a 60-year-old man who underwent total pelvic exenteration following the diagnosis of rectal cancer. He developed fever and abdominal pain, 7 weeks postoperatively. Computed tomography revealed small bowel dilatation and fluid retention and two caliber changes in the upper pelvis. The left urinary tract ran near the caliber changes, and we observed upstream hydronephrosis. We suspected closed loop formation and strangulation ileus caused by the left urinary tract. We performed laparotomy and observed that the small bowel was inserted into the dorsal aspect of the left ureter-ileal conduit, which resulted in an internal hernia. Ileus secondary to a reconstructed ureter is rare, and only 10 cases have been reported in Japan and overseas.