会陰部への腸管 Pull-Through を施行した総排泄腔外反症 : 術後排便機能について

概要

論文の詳細を見る
An infant was admitted with a diagnosis of cloacal exstrophy associated with omphalocele and imperforate anus. An intravenous pyelogram demonstrated a left single kidney. Seven days after birth, ileostomy was performed. Ten months later, double appendectomy, hindgut augmentation, turn-in the bladder, urethroplasty, and bilateral iliac osteotomies were performed. As there was good contraction of the external sphincter to the electric stimulation, some pelvic muscles in CT scanning examination, and no neurological anomaly, abdomino-sacro-perineal pull-through for imperforate anus was carried out. The residual colon was about 20cm long. Three months later, ileostomy closure was done. Now, the patient is 7 years old and she has 3 to 4 semi-solid bowel movements daily. But she soils her diaper with her stools almost everyday. Barium enema, CT scan and manometric study suggest some sphincteric mechanizm for the feces. In some adequate cases, pull-through procedure for the imperforate anus should be taken into consideration.
日本小児外科学会の論文
1991-10-20