溃疡性结肠炎(UC),主要由粘膜病变组成,很少形成膀胱或直肠膀胱瘘,尽管很少报道与合并症相关的瘘管形成病例。我们报告了一例与直肠膀胱瘘相关的症状后诊断为UC相关的直肠癌。一名40岁的男子,有31年的广泛UC病史,排便困难。在本次演讲前两年,他经历过气尿,然后检查发现直肠肿瘤病变和直肠膀胱瘘;然而,组织活检显示无恶性肿瘤。因此,他要求观察,没有进一步的治疗。目前的检查表明直肠肿瘤已经侵入膀胱。组织活检未见恶性肿瘤。然而,临床症状和检查结果强烈提示UC相关性直肠癌伴膀胱浸润;行开放式全直肠结肠切除术和膀胱部分切除术.直肠肿瘤病变的组织病理学评估显示UC相关的直肠癌起源于炎性粘膜,发现直肠膀胱瘘是由直肠癌侵入膀胱引起的。因此,即使UC伴瘘管患者的组织活检未发现恶性病变,也应考虑其他结直肠癌.
Ulcerative colitis (UC), which mainly consists of mucosal lesions, rarely form colovesical or rectovesical fistulas, although few cases of fistula formation associated with comorbidities have been reported. We report a
case of UC-associated rectal cancer diagnosed following symptoms associated with rectovesical fistula. A 40-year-old man with a 31-year history of extensive UC presented with difficulty in defecation. Two years before the current presentation, he had experienced pneumaturia, and the examination then had revealed a rectal neoplastic lesion and rectovesical fistula; however, tissue biopsy showed no malignancy. Therefore, he requested for observation with no further treatment. Current examination suggested the rectal tumor had grown to invade the bladder. Tissue biopsy showed no malignancy. However, the clinical symptoms and examination findings strongly indicated UC-associated rectal cancer with bladder invasion; thus, open total proctocolectomy with partial cystectomy was performed. Histopathological evaluation of the rectal neoplastic lesion revealed UC-associated rectal cancer originating from the inflammatory mucosa, and the rectovesical fistula was found to be caused by the rectal cancer invading the bladder. Therefore, other colorectal cancers should be considered even though tissue biopsy does not reveal malignant lesions in UC patients with fistula.