大腸全摘後の尿路結石についての検討

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Five cases of urolithiasis were experienced among 58 cases of total proctocolectomy. In two cases the stone components were analyzed to be uric acid and ammonium urate, respectively.1) Urinary pH after total proctocolectomy was lower than normal or partial colon resction. Urinary pH after ileo-rectal anastomosis, in which rectum was preserved 10 to 15cm in length, distributed in a wide range and its mean value was between that of proctocolectomized state and normal cases. As to urinary pH, ileo-rectal anastomosis is thought to be a limit to keep the urinary lithogenesity at a minimum level.2) Urine after total proctocolectomy frequently precipitated into sediment. Chief components of the sediment were uric acid and calcium oxalate, the ratio 73:27. When urinary pH was under 5.6 and was incubated at 4°C, the sediment appeared in 88.6% of cases. On the other hand, it was observed in only 21.4% of cases, if the urinary pH was over 5.7. Urinary Na/K and sodium excretion lowered in total proctocolectomized cases.3) Causes of uric acid stone after total proctocolectomy is thought to be due to lowered urinary pH and decreased urinary sodium and water output.
財団法人日本消化器病学会の論文