A Case of Rectovagino-vesical Fistula due to Radiation Therapy for Uterine Cancer Treated with Covered Expandable Metallic Stent.

概要

論文の詳細を見る
A 65-year-old woman had received a panhysterectomy and radiation therapy for a uterine cancer in 1974 and underwent a drainage operation for a peritonitis due to rupture of the bladder associated with radiation cystitis in 1983. A rectovesical fistula was revealed and partial resection of the bladder and rectum was performed in 1996. In 1998, rectovesical fistula recurred and symptom of fecaluria and contact-type dermatitis at perineal region subsequently worsened. In February, 2000, colonoscopy and gastrograffin-enema revealed a giant rectovagino-vesical fistula. Although we recommended ileostomy, the patient refused our offer. She gave informed consent to our proposal about the insertion of a covered expandable metallic stent (EMS) into the rectum to treat for fecaluria. After insertion of the covered EMS, fecaluria and contact-type dermatitis at perineal region subsequently improved. Three months later, fecaluria appeared again. Finally, seven months later, severe inflammation occurred at perineal and pubic region because of migration of the covered EMS into the bladder, then we removed the covered EMS and performed ileostomy. It is difficult to use the covered EMS treatment for benign rectovesical or rectovaginal fistula for a long term.
社団法人日本消化器内視鏡学会の論文