A CASE OF APPENDIX CANCER FORMING A VESICAL FISTULA

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A case of appendix cancer which formed a vesical fistula was experienced. A 70-year-old man was admitted to the hospital because of hematuria and urodynia. Hematological examination revealed no abnormalities. CEA value was normal, 1.0ng/ml. Based on an abdominal CT scan, he was diagnosed as having an intraperitoneal abscess and underwent puncture drainage. The patient was discharged, but thereafter cloudy urine persisted and redness and pain in the abdomen developed. The patient was re-admitted, when CEA value increased to 6.6ng/ml. Fistulography confirmed a communication with the bladder. Excochleation of the abscess part and partial cystectomy were carried out. A part of appendix resected was histologically diangosed as well differentiated adenocarcinoma. The patient had been recieving chemotherapy, and about one year and 3 months after the operation, an increase in CEA to 5.0ng/ml was observed. A recurrence was suspected and the patient was reoperated on. A tumor in the presarcral space was found and extirpated. Thesmall and large intestines were not involved. The bladder was also normal. This is a relatively uncommon case of bladder-digestive tract fistula, in.the which we had difficulties in the diagnosis.
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