内科的および外科的治療が各々奏効した上腸間膜動脈塞栓症の2例

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  • ナイカテキ オヨビ ゲカテキ チリョウ ガ オノオノ ソウコウ シタ ジョウチョウカンマク ドウミャク ソクセンショウ ノ 2レイ
  • Two Cases of Superior Mesenteric Artery Embolism Responding to Medical and Surgical Treatment

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type:TOHO University Scholarly Publication

症例

【症例1】79歳,男性.腹痛・嘔吐・下痢を主訴に受診.腸炎の診断で入院となるも,翌日意識レベルの低下認め腹部CT検査を施行し,上腸間膜動脈(SMA)血栓に伴う腸管壊死が疑われ,緊急手術を施行した.【症例2】85歳,男性.腹痛を主訴に受診.精査にてSMAに血栓を認めた.腸管は一部造影効果不良域あるも,発症から比較的早期であり血栓溶解療法を施行した.死亡率が高い本疾患に対し治療が奏効した2例を経験したので報告する.Superior mesenteric artery (SMA) embolism is associated with a high mortality rate. We herein report two cases of SMA embolism successfully treated with medical and surgical treatment. The first case was a 79-year-old man who was admitted with abdominal pain, vomiting, diarrhea, and diagnosed with enteritis. The day after admission, he underwent contrast-enhanced computed tomography (CT) to determine the cause of altered consciousness. Intestinal necrosis due to a thrombus in the SMA was suspected, and he underwent emergency surgery. The second case was an 85-year-old man who was admitted with abdominal pain. A thrombus in the SMA was detected on contrast-enhanced CT, and partially poor contrast enhancement was observed in the small intestines. The time from symptomatic onset to admission was 6 hours, which was relatively short; therefore, he underwent thrombolytic therapy and exhibited clinical improvement.

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