症例は75歳の男性で，胸部食道扁平上皮癌，内視鏡治療後の肺転移・副腎転移・腹膜播種再発に対し，通院による症状緩和を実施中であった．腹痛・嘔吐を主訴に受診し，腹部CT，上部消化管造影検査にて十二指腸結腸瘻と診断された．絶食・胃管留置・抗菌薬投与による保存的加療にて腹部症状は改善し，一旦経口摂取が可能となったが，1か月以内で腹痛・嘔吐が再燃した．保存的加療に抵抗性の十二指腸結腸瘻と判断し，緩和手術として胃空腸吻合術と右側結腸分離術を併施した．重篤な術後合併症は認めず，術後3か月現在，経口摂取が可能な状態で通院加療中である．胃空腸吻合術と右側結腸分離術は，十二指腸結腸瘻に対する緩和手術として安全性とQOLの観点から有用な術式と考えられた．

Accidental ingestion or inhalation of dental objects during daily clinical practice may cause various clinical complications such as damage to the digestive tract, abscess formation, peritonitis, septicemia, pneumonia, foreign-body granuloma, fistulas and duodenocolic fissures.[1] The severity of the situation depends on the anatomical direction that the object followed and the anatomical locat...

appendicovesical fistula is an uncommon type of enterovesical fistula and a rare complication of unrecognized appendicitis. appendicovesical fistula often presents with recurrent or persistent urinary tract infection, especially in men. the commonest causes are appendicitis, cecal diverticulitis, and cystadenocarcinoma or carcinoid tumors of appendix. approximately 114 cases have been reported ...