ARDSを合併した外傷性膵断裂の1例 TRAUMATIC DISRUPTION OF THE PANCREAS COMPLICATED WITH ARDS -A CASE REPORT-
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交通事故によって発生した膵完全断裂にARDS (adult respiratory distress syndrome)を合併した1例を経験したので文献的考察を加えて報告する.<br> 症例は40歳の男性で,泥酔状態で乗用車運転中の正面衝突事故にて受傷した. CT等の諸検査によって膵損傷が疑われたが,全身状態が比較的落着いていたため保存的治療を開始した.受傷後3日目より低酸素血症及び呼吸困難が出現し,更に胸部単純レントゲン写真の所見等によりARDSと診断した.レスピレーターによる呼吸管理を行ったが効果無く,状況の改善をはかるべくその原因と思われる膵損傷に対して手術を施行したところ, ARDSは次第に改善し,軽快退院した. ARDSの治療には原因の除去が最も重要であるものと思われた.
We recently encountered a patient with complete traumatic disruption of the pancreas due to a traffic accident, complicated with adult respiratory distress syndrome (ARDS), and we discussed the case with reference to the literature.<br> The patient was a 40-year-old man, who was injured in a head-on crash while driving his car when severely drunk. As a result of various examinations including CT, etc., damage to the pancreas was suspected, but conservative treatment was started because his general condition was relatively stable. However, three days after injury, hypoxemia and dyspnea appeared and continued thereafter, and accordingly, the patient was diagnosed as having ARDS from plain chest roentgenography findings. Although respiratory management was carried out with the use of a respirator, it proved ineffective. Surgery was therefore undertaken for the damaged pancreas under the assumption that this was the cause of the condition. As a result, ARDS gradually improved, and the patient was subsequently discharged from hospital. For the treatment of ARDS, it thus sems most important to remove the cause of the condition.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 48(8), 1148-1153, 1987
Japan Surgical Association