• Journal of Yeungnam Medical Science
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• 제23권1호
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• pp.108-112
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• 2006

The frequency of a bladder foreign body in the female is lower than in the male, and bladder stones attached to foreign bodies such as non-absorbable suture material are not common. Moreover, vesicovaginal fistulas due to migration or puncture of suture materials into the bladder are rare. In this report, we present a case of bladder stone and vesicovaginal fistula formation in a 29-year-old female patient who had been treated with the McDonald operation for an incompetent internal os of the cervix (IIOC) during pregnancy. The patient was successfully treated by cystoscopic removal of the bladder stone with suture material and conservative treatment for the vesicovaginal fistula.

• Advances in pediatric surgery
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• 제16권2호
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• pp.190-195
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• 2010

Ileovesical fistula is a rare condition in children. A case of 13 year-old female with ileovesical fistula caused by an ingested foreign material is presented. She had dysuria and lower abdominal pain for one month. There was no history of medico-surgical illness such as Crohn's disease or diverticulitis. Preoperative imaging study showed a movable calcified object in the pelvic cavity and air bubbles in the bladder. At laparotomy a bezoar-like mass was found at the antimesenteric border of the terminal ileum adherent to the dome of bladder. Segmental resection of the ileum and partial cystectomy were performed.

• 대한핵의학회지
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• 제34권1호
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• pp.99-105
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• 2000

Computed tomography (CT) seems to be the best imaging modality to diagnose an enterovesical fistula, but is not always able to demonstrate enterovesical fistula itself. In this case report, we present Tc-99m HMPAO white blood cell (WBC) scintigraphic findings of an enterovesical fistula complicating Crohn's disease. A 22 year-old male presented with a one-month history of urinary symptoms such as dysuria, hematuria, and frequency. The patient had intermittent right lower quadrant pain, diarrhea and hematochezia. Enterovesical fistula was highly suggestive in pelvic CT which showed air density in the urinary bladder, but cystoscopy failed to find an opening of the fistula. Tc-99m HMPAO WBC scintigraphy for evaluation of inflammatory bowel disease incidentally demonstrated enterovesical fistular tract. Crohn's disease was later confirmed by histologic examination of the surgical specimen. In our patient, Tc-99m HMPAO WBC imaging was helpful in determining the location of the fistula as well as assessing the disease activity and extent of the Crohn's disease.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.329-332
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• 2011

Purpose: In developed countries, vesicovaginal fistula occur from various pelvic operations including total hysterectomy, leading to urinary leakage and incontinence. Although various methods have been proposed for adequate tissue coverage in fistula repair, the surgical treatment of is not simple and still controversial. We report a case of neobladder-vaginal fistula repair using modified Martius fat pad flap. Methods: A 62-year-old female patient underwent radical cystectomy with total abdominal hysterectomy and neobladder formation due to invasive bladder tumor 5 years ago. For 3 years following the operation, urine leakage was observed. Exploration demonstrated neobladder-vaginal fistula and primary repair including fistulectomy and direct closure was performed. Urinary incontinence relapsed 2 years after primary repair, and after demonstrating the recurrence of fistula on urography, repair of recurrent fistula was performed. After dissection of vagina and neobladder and closure of fistula by urologic surgeon, fibroadipose flap was elevated, rotated and advanced through the tunnel at vaginal sidewall, and interpositioned to the fistula site between neobladder and vagina. Results: There was no acute complication after the surgery and urethral catheter was extracted on the 8th day after the operation. During six month follow-up period after the operation, there is no clinical evidence of fistula recurrence. Conclusion: From our clinical experience and literature review, we think Martius fat pad flap is a useful technique in management of neobladder-vaginal fistula, for it provides enough vascularity, major epithelization surface and better lymphatic drainage, and also prevents overlapping of vesical, vaginal suture lines at the same time.

• Advances in pediatric surgery
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• 제13권1호
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• pp.76-80
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• 2007

The authors applied anterior sagittal transrectal apporach (ASTRA) for the repair of urethrovaginal fistula which developed after total repair of persistent cloaca. The patient had been diagnosed to have persistent cloaca, double uterus and double vagina, and received PSARP, excision of right-side uterus and vagina, and left vaginal switch operation at 22 months old. After operation, the patient admitted several times due to frequent urinary tract infection and ectopic stone formation in bladder and neovagina. Urethro-neovaginal fistula was confirmed by cystoscopy and corrected with ASTRA. Postoperative voiding cystourethrogram showed no fistula tract. ASTRA showed improved surgical field, minimized ureterocystic damage, and preserved perirectal nerve due to limited incision of rectum.

• 한국수의병리학회:학술대회논문집
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• 한국수의병리학회 2002년도 추계학술대회초록집
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• pp.138-138
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• 2002

A 10-day old male calf exhibited multiple congenital anomalies of the urinary and gastrointestinal tracts, including renal fusion (horseshoe kidney), ureteral fusion, rectovesicular fistula, and atresia ani. The single kidney was fused at the caudal poles. The left kidney and cranial half of right kidney were shrunken, while the remaining lobules were hypertrophic. Ureters were fused cranially and bifurcated caudally. The terminal rectum was narrowed and connected with the bladder. The anus was imperforate. The cause of these anomalies could not be determined. This is the first report of this constellation of congenital anomalies in a calf.

• 대한방사선기술학회지:방사선기술과학
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• 제20권1호
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• pp.43-49
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• 1997

Purpose of this paper is to extend help for clinical application in balloon cholangiography on patients who have undergone endoscopic sphincterotomy, impacted stones of intrahepatic duct, and missed bile duct because of other diseases in operating endoscopic retrograde cholangiopancreatography. This study was done for the patients who had clinical signs of biliary diseases from January to December In 1996. We studied 45 patients who had endoscopic sphincterotomy, re-examination after interventional treatment of the endoscopic retrograde cholangiopancreatography, and uncertain diagnosis due to common bile duct and intrahepatic duct those are not filled with contrast media. Balloon cholangiography was performed in case of uncertain diagnosis while operating endoscopic retrograde cholangiopancreatography. First of all, we insert balloon catheter Into the working channel of treatment jejunofiberscope and remove treatment Jejunofiberscope after ballooning, and lastly take biliary tract X-ray after Injection and changing position of patient. The results of this study were as follows. (1) In classification of diseases, stones of gall bladder, those of common bile duct, and those of intrahepatic duct were 30 cases, fistula was 1 case. (2) In total cases of 45, only diagnosis were 25 cases, interventional treatment were 20 cases. (3) In case of interventional treatment, endoscopic sphincterotomy and endoscopic nasobiliary drainage, and stone removal were about the same, 7, 7, 6 respectively. Balloon cholangiography will be useful to prevent patients from having repeated and unnecessary studies for the cases above explained. It is considered that this study will be useful for clinical application in terms of reducing medical expenses, pain while examination, and consultation hours.

• Radiation Oncology Journal
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• 제8권2호
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• pp.241-253
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• 1990

1980.6.부터 1985.12.까지 고신의료원 치료방사선과에서 방사선 단독 치료한 병기 IIb 자궁경부암 환자 331명에 대하여 후향적으로 생존율 치료 실패 및 합병증 등에 영향을 미칠 수 있는 방사선 치료요소들을 분석조사 하였다. 5년 생존율과 무병생존율은 각각 $82.8{\%}$와 $82.4{\%}$였다. 방사선 치료 6주 경과에 분석한 골반내 관해율은 전골반 외부 조사후 강내조사한 예에서는 $98.6{\%}$였고 축소조사한 추가 치료한 예에서는 $71.6{\%}$였다. 전골반 방사선 조사후 완전관해를 보였던 예에서의 5년 생존율은 $98.9{\%}$였지만 국소치료실패 및 원격전이한 예에서는 $12.9{\%}$였다. Point A에 $7500{\~}8500$ cGy를 조사한 예에서는 $88.5{\%}$의 5년 생존율을 보였고 합병증은 $4.9{\%}$였지만 그 이상의 조사량에서는 생존율은 증가한지 않았고 합병증만 증가하였다. $18.7{\%}$(62예)에서 치료실패를 보였는데, 이중국소치료실패가 $72.6{\%}$(45예), 국소 및 골반임파 치료실패가 $3.2{\%}$(2예)였으며 원격전이 실패는 $24{\%}$(15)였다. 합병증은 $15.1{\%}$(50예)였는데 이중 $42{\%}$가 직장 출혈 및 협착이였다. Point A의 조사량은 8500 cGy가 합병증 유발의한계 조사량 이였으며 합병증의 $70{\%}$가 그 이상의 조사양에서 발생하였다. 직장 합병증은 6500 cGy이상에서 발생하였고 방광합병증은 7500 cGy이상에서 발생하였다. 사망의 원인으로는 국소치료실패로 인한 전신쇠약이 대다수였으며 전체 사망원인으로는 국소치료 실패로 인한 전신쇠약이 대다수였으며 전체 사망원인의 $73.7{\%}$였고 그외 폐, 간, 뼈 전이순이였으며 방사선합병증으로 인한 사망은 3예에 지나지 않았다. 상기와 같은 결과에 대한 결론으로 크기가 아주 큰 종양이나 Barrel형태의 종양의 방사선 치료에는 지금 많이 사용되고 있는 4000 cGy이상의 외부 조사량이 강내조사전에 골반관해를 성취하기 위해 필요한 것을 알 수 있었다.