ileal bladder enlargement

Intestinal bladder enlargement includes ileal, colon, and ileocecal enlargement of the bladder, with ileal and sigmoid bladder enlargement being more common. Treatment of diseases: bladder tumors, kidney tuberculosis Indication 1. Urinary tuberculosis, the diseased kidney has been resected, the bladder has been scarred, the bladder capacity is less than 100ml, and the anti-tuberculosis drug has been treated for more than half a year. There is no pus ball or tuberculosis in the urine, and other parts of the body have been stabilized. 2. Non-inflammatory urinary frequency, bladder volume within 50ml. 3. Female interstitial cystitis is not cured for a long time. 4. Bladder tumors undergo partial cystectomy. The bladder volume is too small, or the bladder is completely resected. 5. There are serious complications after ureteral sigmoid anastomosis, which can not be controlled, and the lower urinary tract has returned to normal. Contraindications 1. Severe urethral stricture, can not be cured in a short period of time. 2. Bladder urethral sphincter dysfunction. 3. Patients with lesions in the ileum or colon (such as tuberculous lesions or multiple diverticulum). 4. There are still progressive tuberculosis in the systemic or urinary system. Preoperative preparation 1. On the 3rd day before surgery, enter a high-calorie, high-protein, low-slag diet to strengthen nutrition; 24 hours before surgery to give a fluid diet (double). 2. Sulfonamide 1g, 4 times a day, for 3 consecutive days. Or oral streptomycin was started 36 hours before surgery, 0.5g every 6 hours. 3. A few days before surgery, 200ml saline can be enema once, so that it stays and walks down to test whether there is no incontinence. 4. For 48 and 24 hours before surgery, each serving was 15 ml of castor oil. On the 2nd day before surgery, 2000ml of warm saline was used every night. Two hours before surgery, 500 ml of 1% neomycin was used for rectal enema to remove intestinal dirt. 5. Blood potassium, sodium, chloride and co2 binding 6. Need to pay attention to pre-operative driving. Surgical procedure 1. Incision: From the pubic symphysis to the pubic symphysis and the midpoint of the umbilicus, then fold to the upper right to the midpoint of the umbilicus and anterior superior iliac spine. 2. Free ileum: After laparotomy, a section of the ileum with good blood supply and about 15 cm long was cut off at 15 cm from the ileocecal valve. The free intestinal fistula was washed repeatedly with normal saline and 1% neomycin solution until the liquid was clear. The proximal end of the free intestinal fistula was sutured closed, the inner layer was sutured continuously with a 2-0 gut, and the outer layer was sutured with a silk suture. 3. Ileum bladder anastomosis: the unhealthy part of the bladder wall was excised, the remaining part was anastomosed to the distal end of the free ileal fistula, the inner layer was sutured continuously with a 2-0 chrome gut, and the outer layer was sutured with a thin wire. . The cigarette was drained from the anastomosis and was taken out from the lower end of the incision. An indwelling catheter is inserted from the urethra to drain the bladder. 4. Close the peritoneum: Place the free intestinal fistula outside the peritoneum, and suture the free intestinal mesenteric margin and the posterior peritoneum to avoid the formation of internal hemorrhoids. Then, the abdominal wall incision is sutured layer by layer.