Enterovesical fistula caused by non-Hodgkin’s lymphoma of the ileum: report of a case

We herein present a rare case of enterovesical fistula caused by ileal non-Hodgkin’s lymphoma. A 75-year-old Japanese male presented with macrohematuria at Kosei General Hospital in December 2010. An egg-sized mass was palpable in his right lower abdominal region, and computed tomography (CT) reveal...

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Veröffentlicht in:Surgery today (Tokyo, Japan) Japan), 2012-10, Vol.42 (10), p.1005-1009
Hauptverfasser: Shinji, Seiichi, Akimaru, Koho, Tsuchiya, Yoshikazu, Shimizu, Tetsuya, Kawamoto, Masao, Iwamoto, Miki, Yamaguchi, Noritaka, Suzuki, Hiroo, Yamada, Takayuki, Nikaido, Takashi, Uchida, Eiji
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Sprache:eng
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Zusammenfassung:We herein present a rare case of enterovesical fistula caused by ileal non-Hodgkin’s lymphoma. A 75-year-old Japanese male presented with macrohematuria at Kosei General Hospital in December 2010. An egg-sized mass was palpable in his right lower abdominal region, and computed tomography (CT) revealed that the ileal tumor had invaded the right posterior wall of the urinary bladder (UB). A histopathological examination of a CT-guided needle biopsy specimen revealed diffuse large B-cell lymphoma involving the ileum and the UB. Thereafter, fecaluria appeared. A transurethral catheter was put in place, and there were no symptoms of cystitis. The patient received chemotherapy for the lymphoma, which produced a partial response. However, the fecaluria continued, and an examination of the small intestine with contrast revealed a thick and irregular wall of the ileum and a fistula between the ileum and UB. A partial resection of the ileum and a partial cystectomy were carried out in April 2011. The surgical specimen demonstrated two tumors 5 cm apart in the ileum, measuring 4.5 × 7 and 4 × 3 cm in size. The proximal tumor had directly invaded the UB and formed an ileovesical fistula. The patient made a good recovery and was doing well 5 months after the surgery without any evidence of recurrence.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-012-0177-x