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目的总结精囊腺肠瘘的病因、临床表现和诊治方法。方法查阅国内外关于精囊腺肠瘘的临床报道的文献,对其病因、临床表现及诊治方法进行分析。结果共查阅到19例精囊腺肠瘘的相关临床报道。精囊腺肠瘘多发生于直肠低位前切除术后伴发吻合口漏、乙状结肠憩室、炎性肠病、前列腺切除或放疗后。症状主要表现为气尿、粪尿、发热、阴囊肿胀疼痛、睾丸炎、附睾炎等。多经增强CT或CT加直肠对比等影像学方法确诊。经留置尿管、抗生素应用、肠外营养等保守治疗和窦道切开引流、黏膜或骨骼肌瓣修补、尿或粪便转流等手术方法多可治愈。结论精囊腺肠瘘是一种少见且独立的疾病,通过对精囊腺肠瘘的分析,以提高对其的认识,避免误诊、误治。
Objective To summarize the etiology, clinical manifestation, diagnosis and treatment of seminal vesicle fistula. Methods The literatures about the clinical reports of seminal vesicle fistula at home and abroad were reviewed and the etiology, clinical manifestations, diagnosis and treatment methods were analyzed. Results A total of 19 cases of seminal vesicle intestinal fistula related clinical reports. Seminal vesicle fistula occurred in the anterior resection of low rectal anastomotic leakage, sigmoid diverticula, inflammatory bowel disease, prostatectomy or radiotherapy. Symptoms mainly for air, urine, fevers, scrotal swelling and pain, orchitis, epididymitis and so on. Multiple enhanced CT or CT plus rectal contrast imaging methods such as diagnosis. After indwelling catheter, antibiotics, parenteral nutrition and other conservative treatment and sinus incision and drainage, mucosal or skeletal muscle flap repair, urine or fecal flow and other surgical methods can be cured. Conclusion Seminal vesicle gastrectomy is a rare and independent disease, through the analysis of seminal vesicle gland fistula in order to enhance its understanding and avoid misdiagnosis and mistreatment.