鈍的外傷による脾内仮性動脈瘤の1例  [in Japanese] A CASE OF INTRASPLENIC PSEUDOANEURYSM AFTERBLUNT ABDOMINAL TRAUMA  [in Japanese]

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Abstract

鈍的外傷による脾損傷の保存的療法中に脾内仮性動脈瘤を生じた症例を報告する.<br>33歳女性,交通事故にて搬送,肝外側区損傷(IIIa)と脾損傷(IIIa)を認めた.保存的療法で安定した状態であったが経過観察のため施行した第9病日のCTで,脾内にやや造影効果の強い領域があり,超音波検査では低エコーレベルの嚢胞状の領域として描出,第16病日にはdynamic CT,超音波検査で増大した血栓を伴った動脈瘤と確認された.第23病日に動脈塞栓術(TAE)を施行,その後問題なく経過しているが約10カ月後もCTで造影されず低エコーレベルの小領域が脾内に認められた.<br>脾内仮性動脈瘤は遅発性脾破裂の一因といわれている.脾損傷で保存的療法や脾温存手術を選択した場合,計画的な画像診断による経過観察で破裂前に発見治療することが望まれる.

A 33-year-old woman was trasported to the hospital after being involved in a steering wheel injury. She was diagnosed as having injuries in the lateral segment of the liver and the upper pole of the spleen by CT and echo. All her vital signs were stable and she was treated conservatively.<br>A follow-up CT on hospital day 9 revealed a highly enhanced lesion in the spleen. It became larger and was diagnosed as pseudoaneurysm with thrombi on day 16. The patient had a successful arterial embolization on day 23. And after that she had an uneventful recovery. Ten months later, just a small low density lesion could be identified at the spleen.<br>Intraspleic pseudoaneurysm, one of the causes of delayed rupture of the spleen, can be managed with embolization by meticulous follow up before rupture, if conservative therapy or spleen preserving operation is selected for splenic injuries.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 60(8), 2207-2211, 1999-08-25

    Japan Surgical Association

References:  11

Cited by:  1

  • Clinical Points of MDCT (Multi-detector row CT) in Children  [in Japanese]

    KITAGAWA Hiroaki , NAKADA Koonosuke , KAWASE Hirokazu , WAKISAKA Munechika , SATO Yuriko , SATO Hideaki , FURUTA Shigeyuki , KONDO Mutsuko , MIYAZAKI Osamu

    日本小児放射線学会雑誌 = Journal of Japanese Society of Pediatric Radiology 18(3), 171-179, 2002-12-20

    Ichushi Web  References (15)

Codes

  • NII Article ID (NAID)
    10008496473
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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