慢性腎不全に合併したａｂｄｏｍｉｎａｌ　ａｎｇｉｎａにｐｒｏｓｔａｇｌａｎｄｉｎ　Ｅ１が有効であった３症例

DOI 被引用文献2件 参考文献29件

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  • Three cases of abdominal angina in patients with chronic renal failure: successful treatment with prostaglandin E1

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We report here 3 cases of abdominal angina in patients with chronic renal failure, and they were successfully treated with intravenous administration of prostaglandin E1 (PGE1). Abdominal angina is a disease with a classical triad of abdominal pain after food intake, weight loss, and fear of eating due to the abdominal pain. The cause of this syndrome is mainly stricture of the main abdominal arteries and chronic intestinal ischemia. Progression of abdominal angina triggers main abdominal arterial obstruction, extensive bowel necrosis, and is sometimes fatal. In addition to its poor prognosis, the frequent appearance of abdominal pain and discomfort seriously diminishes the patient's QOL. Atherosclerosis is the cause of about 50% of the cases of stricture of the main abdominal arteries. However, chronic renal failure patients with or without dialysis who often have concomitant disease-induced atherosclerosis, might become complicated by abdominal angina. The first choice of treatment for this syndrome is usually surgical bypass or revascularization of the main arteries. However, patients with chronic renal failure possess concomitant diseases, such as obstructive arteriosclerosis, ischemic heart disease, etc., resulting in a high risk for surgical procedures. Medical treatment without any surgery may be preferable for abdominal angina, especially as a complication of chronic renal failure, however, there is still no commonly acceptable medical treatment.<br>We treated 3 cases of abdominal angina with chronic renal failure by intravenous administration of PGE1. PGE1 successfully reduced the degree and the frequency of patients' symptoms. These patients, who had renal failure with several complications, were not considered to be able to tolerate surgical treatment. PGE1, which is a potent vasodilator, was effective for their symptoms. Our experience with these cases suggested that drip infusion of PGE1 could e one of the choices for non-surgical treatment of abdominal angina as a complication in patients with chronic renal failure.

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