[A CASE OF PERIVESICAL ABSCESS CAUSED BY MIGRATION OF A FOREIGN BODY FROM THE INTESTINAL TRACT].

Rintaro Yoshitake, Masato Baba, Shigetoshi Kubota, Susumu Kageyama, Akihiro Kawauchi
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Abstract

A 76-year-old woman was referred to our department because of high fever and bladder irritative symptoms. Computed tomography revealed the presence of a heterogeneous mass with indistinct borders on the left anterior wall of the bladder. The lesion contained a linear hyperdense shadow. We initially suspected malignancy, such as urachal carcinoma or soft-tissue sarcoma. However, upon review of previous computed tomography scans, it was confirmed that the linear hyperdense shadow had migrated from the intestinal tract to the bladder. Considering the possibility of abscess formation caused by a foreign body, we decided to perform a transurethral biopsy. The results of the pathological analysis showed abscess formation. The patient was diagnosed with perivesical abscess caused by accidental ingestion of a fish bone. Following the administration of antibiotics, the lesion markedly shrank. Although it is difficult to distinguish perivesical abscess from malignant disease, invasive treatment can be avoided by appropriate diagnosis based on imaging studies.

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[肠道异物移位引起的膀胱周围脓肿病例]。
一名 76 岁的妇女因高烧和膀胱刺激症状被转诊至我科。计算机断层扫描显示,膀胱左前壁存在一个边界不清的异质肿块。病灶内有线状高密度影。我们起初怀疑是恶性肿瘤,如尿道癌或软组织肉瘤。然而,在复查之前的计算机断层扫描后,证实线性高密度影是从肠道转移到膀胱的。考虑到异物可能导致脓肿形成,我们决定进行经尿道活检。病理分析结果显示有脓肿形成。患者被诊断为膀胱周围脓肿,由误食鱼骨引起。使用抗生素后,病灶明显缩小。虽然很难将鳃周脓肿与恶性疾病区分开来,但通过影像学检查进行适当诊断,可以避免进行侵入性治疗。
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