エアバック損傷にて腹腔内出血をきたした胃平滑筋肉腫の1例

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  • A CASE OF GASTRICLEIOMYOSARCOMA CAUSING INTRAABDOMINAL BLEEDING DUE TO AN AIR BAG INJURY

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A 48-year-old man had clashed with a central separating line on a highway when he had been driving his car equipped air bag after drinking about five a.m. on November 2, 1996. He had not worn a seat belt, but the air bag operated. Once he went to the office, but an abdominal pain that he had at the clash was intensified and he was transferred to the hospital by an ambulant car about eleven a.m. There were prominent abdominal distension and tenderness in the entire abdomen. Abdominal CT revealed intraabdominal bleeding and a tumor with high and low density portions concomitantly on the posterior wall of the stomach. An emergency operation was carried out, and approximately 1.5l of hemorrhagic ascites was noted, as well as an extramurally growing tumor with the size of 95×85×62mm in the posterior wall of the middle portion of the gastric body adjacent to the greater curvature. The surface of the tumor was irregular and elastic hard. The tumor itself presented a state of hemangioma and bled. A gastrectomy was conducted with a diagnosis of leiomyosarcoma of the stomach. Histopathologically it was leiomyosarcoma of low grade of malignancy. The postoperative course was uneventful and the patient was discharged from the hospital on the 24th hospital day. When only airbag operates without wearing a seat belt, in almost all cases, the face, neck, and chest are injured and the abdomen is rarely involved. It is thought interesting that this case had an abdominal injury in which only gastric leiomyosarcoma was injured and other organs were intact.

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