直腸癌術後再発の化学放射線療法後に直腸精嚢瘻が疑われた1例

A case of suspected rectal seminal vesicle fistula after chemoradiotherapy for recurrence after rectal cancer surgery

直腸精嚢瘻（rectal seminal vesicle fistula：RS）はまれな病態である。我々は直腸癌術後再発に対して，放射線療法を施行した後にRSを合併したまれな1例を経験したので，若干の文献的考察を加えて報告する。

Rectal seminal vesicle fistula（RS）is a rare condition. Here, we report a case of rectal cancer recurrence with RS after radiotherapy. A 59-year-old man with stage Ⅲ rectal cancer underwent ultralow anterior resection. After 2 years, local recurrence occurred, and radiotherapy was performed. Nine months after ending irradiation, the patient complained of pneumaturia. Computed tomography revealed multiple air images in the sperm sac；thus, RS was clinically diagnosed. It was assumed that the rectal mucosa became inflamed as a side effect of radiotherapy, creating a fistula with seminal vesicles. Although such cases required surgical treatment in previous studies, conservative treatment resulted in improvement and no recurrence in our case.