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病例:男性,67岁。于一年前反复出现排尿不畅,尿流不成线,下腹部胀痛,在当地医院诊断为前列腺增生症。两天前在县医院行“经膀胱前列腺切除术”,术中见膀胱后壁至三角区粘膜下有一肿块,因无法切除而关闭切口,留置耻骨上膀胱造瘘管,尿道留置导尿管。术后第二天转入我院。发病以来无发热,无明显消瘦,时有大便不畅,粪便呈扇形,排便时下腹部胀痛加重,无粘液便及脓血便,查体;腹部胀满,有压痛,轻度反跳痛。下腹部正中见一手术切口。有耻骨上膀胱造瘘管及留置导尿管,直肠指诊:距肛门口上方约8cm处膀胱直肠窝可触及一
Case: male, 67 years old. Repeated a year ago, poor urination, urinary flow, lower abdominal pain, diagnosis of benign prostatic hyperplasia in the local hospital. Two days ago in the county hospital line “transurethral resection of the prostate”, intraoperative see the bladder wall to the triangle submucosal tumor has a mass, because of unresectable and close the incision, indwelling suprapubic bladder fistula, urethral indwelling catheter. The day after surgery into our hospital. Since the onset of fever, no significant weight loss, when there is poor stool, feces were fan-shaped, abdominal pain during defecation aggravated, no mucus and pus and blood stool, physical examination; abdominal fullness, tenderness, mild rebound tenderness. In the middle of the lower abdomen see a surgical incision. There are suprapubic bladder fistula catheter and indwelling catheter, digital rectal examination: from the anus about 8cm above the bladder rectal fossa can reach a