@article{oai:redcross.repo.nii.ac.jp:02001549,
 author = {小西, 里奈 and 岡, 英明 and 櫻井, 裕子 and 岡留, 淳 and 上原, 景大郎 and 木船, 美佳 and 森田, 洋平 and 上村, 太朗},
 issue = {1},
 journal = {松山赤十字病院医学雑誌, The Matsuyama Red Cross Hospital Journal of Medicine},
 month = {Dec},
 note = {仙髄領域の帯状疱疹に膀胱直腸障害を合併し，4週間の対症療法で自然軽快した症例を経験した．症例は79歳女性で，IgA 腎症による末期腎不全で2年前より腹膜透析を継続していた．皮疹出現の1週間ほど前から食欲が低下し，2kg の体重減少と尿量低下を自覚していた．皮疹を伴う右臀部と肛門の痛みで近医を受診し，帯状疱疹と診断され，アメナメビルとメコバラミンを処方された．翌日，右下肢の痺れが出現して当科を受診し，入院加療を開始した．皮疹は2週間で痂皮化したが，第9病日に尿失禁を契機に帯状疱疹による神経因性膀胱の診断に至った．その後は間欠的導尿とウラピジル，ベタネコール内服を継続し，発症から4週間で導尿が不要となった．同時に認めた排便障害も対症療法で約2週間で改善した．本症例のように臀部の帯状疱疹では膀胱直腸障害を来すことがある．末期腎不全による慢性的な尿量低下と，食思不振による脱水が背景にあり，診断に難渋した症例であり，教訓的な症例と考え，ここに報告する．, We report the case of a79-year-old woman with herpes zoster in the sacral medullary region complicated by a cysto-rectal disorder, which resolved spontaneously after four weeks of symptomatic treatment. For two years, the patient had been on peritoneal dialysis for end-stage renal failure due to immunoglobulin A nephropathy. One week before the skin rash appeared, her appetite decreased, weight decreased by 2kg, and urine output decreased. She was diagnosed with herpes zoster and prescribed amenamevir and mecobalamine. The next day, she experienced numbness in the right lower extremity and was admitted to our hospital. The skin rash crusted over within two weeks. However, following urinary incontinence on the ninth hospitalization day, she was diagnosed with neurogenic bladder secondary to herpes zoster. Treatment comprised intermittent urinary drainage and a course of urapidil and bethanechol ; the
urinary drainage requirement subsided within four weeks of onset. Defecation disorder resolved with symptomatic treatment within two weeks. Herpes zoster of the buttocks can lead to bladder and rectal problems, as in this case. Furthermore, diagnosis in our case was made difficult by a chronically low urine output due to end-stage renal failure and dehydration due to a poor diet.},
 pages = {53--58},
 title = {仙髄領域に発症した帯状疱疹による 膀胱直腸障害の1例},
 volume = {48},
 year = {2023}
}