膀胱腸裂5例の臨床的検討 : 特に治療面から

概要

論文の詳細を見る
Vesicointestinal fissure is a complex malformation which consists of exstrophy of the bladder and the intestine, and associates many other anomalies, such as omphalocele, imperforate anus, short colon, malrotation of intestine, urogenital anomalies, separation of symphysis, with a high frequency. We have treated 5 cases with this malformation, three of them being alive and well. Their ages range from 3 years and 8 months to 16 years at present. Two cases died of nutritional depletion and sepsis. Conservative therapy was performed for omphalocele in all cases. Hernia sac shrank rapidly, and abdominal wall closed in about 40 days. For intestinal anomalies, one of 3 survivals had a permanent ileostomy; two had an initial ileostomy with later conversion to an end-colostomy. An anoplasty was performed is one of the two since his external sphincter muscle reacted well to electric stimulation and distal colonic segment developed about 30 cm in length. For bladder exstrophy, three had primary closure. They could't achieve urinary continence at all. One of them underwent an ileal-coduit afterward. For separation of symphysis, two had iliac osteotomy. We collected 63 cases from the Japanese literature and found that only 12 of them survived. Treatments of vesico-intestinal fissure were discussed from several aspects.
日本小児外科学会の論文
1986-12-20