上腸間膜動脈解離の臨床的検討  [in Japanese] Clinical study of dissection of the superior mesenteric artery  [in Japanese]

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Abstract

上腸間膜動脈解離6症例につき検討した.高血圧を4例に認め,危険因子として考慮された.症状の特徴として,背部に放散する高度の腹痛,背部痛,食後の症状増悪,腸雑音の減弱が挙げられた.診断にはCTや腹部超音波検査が有用であった.抗血栓凝固薬で保存的に管理し,4例が改善した.改善しない2例については厳重に経過を観察し,増悪するようなら侵襲的治療を考慮する必要がある.本疾患として加療されていることもあり,腹痛の鑑別診断上忘れてはならない疾患であると考えられた.

Six patients with dissection of the superior mesenteric artery (SMA) who were treated at our hospital between 1993 and 1999 were studied. Hypertension was considered significant as a risk factor. The clinical features were characterized by severe abdominal pain which radiated posteiorly, back pain, weak bowel sounds and exacerbation by eating. An ultrasonographic examination and a computed tomographic scan of the abdomen were useful for diagnosis. Four cases showed full recovery under conservative management with anticoagulant or antiplatelet drugs. Two cases without recovery should be considered intervention if they have progressive courses. This disease should be kept in mind on differential diagnosis of abdominal pain, because it may be overlooked without a correct diagnosis.

Journal

  • Nippon Shokakibyo Gakkai Zasshi

    Nippon Shokakibyo Gakkai Zasshi 99(2), 145-151, 2002-02-01

    The Japanese Society of Gastroenterology

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