腹部主要血管と腹部救急　　腹部主幹動静脈損傷例の検討

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  • A Study on Cases of Injuries of the Main Abdominal Arteries and Veins.

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We divided injuries of the main abdominal vessels into three categories, namely, injury due to general abdominal trauma, iatrogenic injury, and injury due to anomalies in vascular arborization, and studied the seven cases we encountrered in our department during the past 10 years. There was I case of dull trauma due to a traffic accident in the general abdominal trauma category and 5 cases of iatrogenic injury, 3 of which were due to resection of a malignant tumor and 2 due to operation for a benign tumor (1 case related to laparoscopic surgery). The surgical procedure consisted of replacement of the abdominal aorta in I case, reconstruction of the proper hepatic artery (end-to-end anastomosis) in 2 cases, ligation in 2 cases, and reconstruction of a vein (end-to end anastomosis) in 2 cases. The interval between occurrence of the injury and repair ranged from 15 to 250 minutes. The patient's life was saved and organ ischemia was prevented in every case. Patency was found to have been obtained in every case during follow-up. When injury of the main vessels of the abdomen has occurred and requires emergency treatment, it is necessary to make an accurate and speedy diagnosis and take measures, centering on surgical procedures, to deal with the vessels under time limitations because of organ ischemia.

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