最近経験した総排泄腔外反症の1例と新分類法に基づいた本邦例の集計

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A girl, 3 years 6 months of age, was admittend for the closure of exstrophied bladder. Physical examination and endoscopy were done for anatomical evaluation under general anesthesia. Colostomy had been created in the trasnvers colon. Omphalocele was absent. Exstrophied bladder was located in the lower abdomen. There were 3 orifices, and two of them were identified as bilateral ureteral orifices. The distal orifice was separated into two luminal spaces. The upper space was thought to be vagina and the lower space was connected with rectum. The anus was imperforate. Subsequently we diagnosed the case as a variant form of cloacal exstrophy. At 3 years 10 month of age, primary closure of the exstrophied bladder with the aid of ileostomy were performed. The distal orifice was devided from the exstrophied vesicourethral wall and placed beneath the new urethra. The new classification of cloacal exstrophy was proposed by Manzoni and associates in 1987. Based on this classification. 83 cases those were reported in Japan, were classified;type IA : 1 , IB : 28, IC : 3, IIB : 11, IIC : 3 , unclassified : 37 cases. Cloacal exstrophy is rare and complexanomaly, while there are many variation in forms. As early management is required to save thier lives, the detail of the deranged anatomy, with particular reference to the bowel, urinary tract and genitalia, should be evaluated as soon as possible. Based on these data, they should be managed by ataged and multidiscriplinary cooperation of pediatric surgeon and urologist.
特定非営利活動法人日本小児外科学会の論文
1989-12-20

最近経験した総排泄腔外反症の1例と新分類法に基づいた本邦例の集計

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