Ileo-Sigmoid-Vesical Fistula in a Patient with Williams Syndrome Treated Using One-Stage Surgery: A Case Report

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  • Kii Shuhei
    Department of Surgery, Japan Community Health Care Organization Sapporo Hokushin Hospital
  • Shimokuni Tatsushi
    Department of Surgery, Japan Community Health Care Organization Sapporo Hokushin Hospital
  • Kuratani Yuki
    Department of Surgery, Japan Community Health Care Organization Sapporo Hokushin Hospital
  • Fijiyoshi Sunao
    Department of Surgery, Japan Community Health Care Organization Sapporo Hokushin Hospital
  • Nishikawa Makoto
    Department of Surgery, Japan Community Health Care Organization Sapporo Hokushin Hospital
  • Koike Masahiko
    Department of Surgery, Japan Community Health Care Organization Sapporo Hokushin Hospital
  • Nakanishi Katsuya
    Department of Pathology, Japan Community Health Care Organization Sapporo Hokushin Hospital
  • Takahashi Masahiro
    Department of Surgery, Japan Community Health Care Organization Sapporo Hokushin Hospital

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Other Title
  • S状結腸憩室炎から回腸S状結腸膀胱瘻を発症し一期的手術を行ったWilliams症候群の1例

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Abstract

<p>A 37-year-old man with Williams syndrome diagnosed early in childhood and under regular monitoring presented to the urology department of our hospital complaining of bloody pyuria and frequent urination. Abdominal CT revealed a bladder-infiltrating sigmoid colon tumor and the patient was referred to the gastroenterology department of our hospital. A diagnosis of ileo-sigmoid-vesical fistula due to sigmoid colon diverticulitis was made and he was referred to our department. Intraoperative findings showed multiple diverticula of the descending and sigmoid colon. We performed open left hemicolectomy, partial resection of the small intestine, and partial cystectomy. The patient was discharged uneventfully on postoperative day 11. Williams syndrome is caused by microdeletion of genes on chromosome 7q11.23 and has a relatively low incidence. Colon diverticulosis is likely to occur due to elastin abnormality; however, cases of ileo-sigmoid-vesical fistula in patients with Williams syndrome have rarely been reported. The risk of cardiovascular complications due to anesthesia should be carefully considered during perioperative management, given the high incidence of mental retardation and anxiety disorders in patients with Williams syndrome.</p>

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