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タイトル術前DICを合併した基管大動脈瘤の手術
タイトルヨミジュツゼン DIC オ ガッペイシタ キカン ダイドウミャクリュウ ノ シュジュツ
タイトル別表記Surgery on Chronic Disseminqted Intravascular Coagulation due to Aneurysm : Report of Two Cases
作成者豊田, 秀二
藤田, 雄司
秋山, 紀雄
古谷, 彰
瀬山, 厚司
藤岡, 顕太郎
江里, 健輔
作成者ヨミトヨタ, シュウジ
フジタ, ユウジ
アキヤマ, ノリオ
フルタニ, アキラ
セヤマ, アツシ
フジオカ, ケンタロウ
エサト, ケンスケ
作成者別表記Toyota, Shuji
Fujita, Yhuji
Akiyama, Norio
Furutani, Akira
Seyama, Atsushi
Fujioka, Kentaroh
Esato, Kensuke
作成者所属山口大学医学部
内容記述(抄録等)Aortic aneurysm associated with DIC is rare. We heve experienced two cases with DIC; one with abdominal aortic aneurysm and the other with dissected aneurysm (DeBakey III b type). A 74-year-old woman, who had abdominal aortic aneurysm, was admitted to our hospital because of a large pulsative abdominal mass. Coagulation studies revealed that platelet count (6.2× 10^4/mm^3) and fibrinogen (85mg/dl) decreased and fibrinogen degradation products (FDP) increased to 1486.2 ng/ml. Abdominal CT scan demonstrated that aneuryam was extended from abdominal aorta just distal the origin of the right renal artery to the level of iliac artery. Though she was treated with continuous intravenous administration of Heparin pre-operatively for 36 days, coagulation studies showed no improvement. Aneurysmectomy was performed. She died of multiple organ failure 19 days after surgery. The other patient (a-61-year-old man) complained of back pain. A dissection of the aorta extending fron the descending aorta just distal to left subclavian artery to abdominal aorta just proximal to the origin of renal artery was demonstrated by intraarterial digital subtraction angiogram. Peripheral blood shows RBC 366×10^4/mm^3, fibrinogen 73 mg/dl, FDP 4381 ng/ml and platelet 7.7XlO^4/mm^3. Based on these findings, a diagnosis of DIC due to the dissected aneurysm was made. He received Heparin sodium during 57 days, without resulting in good control. Aneurysmectomy with reconstruction of celiac and superior mesenteric arteries was performed because of enlargement of aneurysm. Bleeding was 16000ml during operation. He died of multiple organ failure two days after surgery. It is difficult to decide the indication for operation on patient that Heparin therapy is no effective for chronic DIC due to aneurysm.
本文言語jpn
著者キーワードDIC
大腸脈瘤
主題医学
資料タイプtext
出版者山口大学医学会
出版者ヨミヤマグチ ダイガク イガッカイ
NII資料タイプ学術雑誌論文
査読の有無査読あり
ISSN0513-1731
NCIDAN00243156
学内刊行物(紀要等)山口医学
掲載誌名山口医学
42
4
開始ページ271
終了ページ277
発行日1993-08
著者版/出版社版その他
リポジトリIDB030042000405
地域区分山口大学
URIhttp://www.lib.yamaguchi-u.ac.jp/yunoca/handle/B030042000405