Destruction of perineal skin and posterior bladder wall as a result of rectum adenocarcinoma’s invasion: a case report

Abstract

A 65 year old man had experienced Miles Operation cause of left colon carcinoma six years ago. Five years later bilateral nephrostomy catheters had placed into his kidneys because of bilateral hydroureteronephrosis. Then he presented at our clinic with an opening at his perineum. He has been complaining of wetness for six weeks. In physical examination anterior wall of the blad­der and tumoral lesion were seen through the perineal hole. General surgeons evaluated the patient as inop­erable relapsing tumor. Bilaterally laparoscopic ureter ligation was performed to finish his wetness complaint. Bilateral laparoscopic ligation makes patient relieved sig­nificantly. Although urine drainage through the hole was stopped secretions from local tissues caused not to re­lieve the complaints of patient completely. Laparoscopic retroperitoneoscopic bilateral ureter ligation may be a pal­liative treatment option for these patients.

Keywords

• Bladder, rectum, perineum, carcinoma, inva­sion

Rektum adenokarsinomunun invazyonu sonucunda perineal cilt ve posterior mesane duvarı harabiyeti: Olgu sunumu

Abstract

Sol kolon karsinomu nedeniyle 6 yıl once Miles Ameliyatı geçirmiş olan 65 yaşında erkek hasta sunulmuştur. Beş yıl sonra iki taraflı hidronefroz tanısı konan hastaya iki ta­raflı nefrostomi kateterleri kondu. Hasta bize perinesinde bir açıklık olduğunu söyleyerek başvurdu. Altı haftadır va­rolan altını ıslatma şikayeti vardı. Fizik muayenede peri­nedeki açıklıktan anterior mesane duvarı ve tümöral yapı varlığı görüldü. Hasta genel cerrahi tarafından inoperabl nüks tümör olarak değerlendirildi. Hastanın altını ıslatma şikayetini gidermek için iki taraflı laparoskopik üreter li­gasyonu yapıldı. Hastada belirgin bir rahatlama izlendi. Yaradan idrar gelişi durmasına rağmen çevre dokulardan gelen doku sıvısı ve sekresyonlar hastanın şikayetlerinin tam olarak geçmemesine neden oldu. Laparoskopik ret­roperitoneoskopik bilateral ureter ligasyonu böyle hasta­larda palyatif bir tedavi yöntemi olabilir.

Keywords

• Mesane, rektum, perine, karsinom, invazyon

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