胸部刺傷後左内胸動脈に発生した仮性動脈瘤の1例 A CASE REPORT OF DELAYED PSEUDOANEURYSM OF THE LEFT INTERNAL THORACIC ARTERY RESULTING FROM STAB WOUNDS

この論文にアクセスする

この論文をさがす

著者

抄録

72歳,男性.既往歴にアルコール依存症があり,同疾患にて近医で入院加療中であった.自宅外泊中に,彫刻刃で自らの左前胸部を20数箇所刺し,近医受診した.胸部CTにて前縦隔血腫と左血胸があったため,当院救命センター搬送となった.CTにて,造影剤の血管外漏出像は無かったが,左血胸の増大があり,緊急血管造影となった.左内胸動脈や左肋間動脈からの出血は無く,出血源は不明であった.受傷部位に相当する第2~4肋間動脈をスポンゼルにて塞栓した.左血胸に対しては,胸腔ドレナージ術を施行した.受傷後7日目の単純CTにて,前縦隔血腫と左血胸の増大ないことを確認し,10日目に転院となった.18日目に呼吸苦を訴え,当院を再受診し,胸部造影CTで左内胸動脈に約5cmの仮性動脈瘤と左胸水の増加を認めた.緊急血管造影を行い,仮性動脈瘤の近位と遠位側にコイル塞栓術を施行した.コイル塞栓術後11日目のCTにて異常無く,前医へ転院となった.

A 72-year-old man stabbed his left chest 20 times by himself with an engraving knife was brought into our hospital by emergency service. His vital signs were stable. The stab wounds were superficial. No bleeding from the stab wounds was confirmed. Chest CT scan showed an anterior mediastinal hematoma and massive left hemothorax. Emergency angiography revealed no active bleeding from the left internal thoracic artery and the left intercostal artery. The origin of the bleeding was unclear, but the 2 ∼ 4 intercostal arteries were suspected as the bleeding sites. We placed a thoracostomy tube into the left thoracic cavity due to the left hemothorax. Plain chest CT scan on the 7th day showed improvement of the anetrior mediastinal hematoma and left hemothorax. He was discharged from our hospital without any complications 10 days after the injury. He was seen at the hospital again because of breathlessness 18 days after the injury, when chest enhanced CT scan showed a 5cm-sized pseudoaneurysm of the left internal thoracic artery and increased left pleural effusion. Arterial embolization was performed. Chest CT scan on the 11th day after the embolization showed no abnormal findings, and the patient was transferred to the previous hospital.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association  

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 69(7), 1633-1637, 2008-07-25 

    Japan Surgical Association

参考文献:  8件

被引用文献:  1件

各種コード

  • NII論文ID(NAID)
    10021944497
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
ページトップへ