膀胱憩室内畸胎瘤并巨大膀胱结石1例报告并文献复习

The report of bladder diverticulum inside teratoma and huge bladder calculi and literature review

目的:探讨原发性膀胱畸胎瘤并膀胱结石的临床表现、病理特征、治疗方法和预后情况。方法:原发性膀胱憩室内畸胎瘤并巨大膀胱结石患者1例,女,45岁,因尿频、尿急、尿痛5+年,排尿不畅伴耻区疼痛半年,腹壁漏尿20d入院。体检:膀胱区稍膨隆,扪及卵圆形质硬肿块,下腹壁红肿压痛,腹壁原手术切口处破溃漏尿。B超及腹部平片(KUB)提示膀胱巨大结石,膀胱造影考虑膀胱憩室并结石。术前诊断:膀胱憩室伴巨大膀胱结石,膀胱腹壁瘘。结果:全麻下行盆腔探查,经耻骨上膀胱切开取石,切除憩室及其内肿物,膀胱部分切除术。术后病检:膀胱成熟囊性畸胎瘤,膀胱结石伴钙盐沉着。随访至今无并发症及复发。结论:原发性膀胱憩室内畸胎瘤并膀胱巨大结石罕见,典型临床表现为从尿路排出毛发或尿石中含有毛发成分。应和单纯膀胱结石相鉴别,确诊需依靠病理检查。治疗行膀胱部分切除,预后良好。

Objective：To discusse the clinical manifest, pathological characteristics, treatment and prognosis of bladder diverticulum inside teratoma and huge bladder calculi. Methods ：One case with bladder diverticulum inside ter- atoma and huge bladder calculi ,female,45 years old,because a frequency,urgency,urine pain 5＋years ,micturition im- peded the abdominal pain during half a year,urinary leakage in the abdominal wall 20 days to the hospital. On exami- nation,a grand of bladder area,and the egg circle of qualitative hard bump ,abdominal wall red tenderness,abdominal wall the original incision urinary leakage in burst. B super and abdominal plain film （KUB） shows bladder calculi huge, bladder imaging consider bladder diverticula and stone. Preoperative diagnosis：bladder diverticula bladder calculi with huge ,bladder abdominal wall fistula. Results ：Anesthesia downside pelvic cavity detection,the cut on the bladder take stone, resection and mass in diverticula, bladder partial nephrectomy. Postoperative disease inspection：bladder cystic mature teratoma,bladder calculi with calcium salt calm. Follow-up so far no complications and recurrence. Con- clusion：Primary bladder inside bladder and huge diverticula teratoma rare stones ,typical and clinical expression fromurinary eduction hair or urine contains hair among components. Should distinguish simple bladder calculi, need to rely on pathology diagnosis. Treatment line radical resection of the bladder,prognosis is good.