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Permalink : https://petit.lib.yamaguchi-u.ac.jp/18703
山口医学 Volume 59 Issue 5-6
published_at 2010-12-31
A case of tuberculous aneurysm of aorta which caused an aortoduodenal fistula and bleeding
十二指腸瘻を形成し消化管出血を来した結核性腹部大動脈瘤の1例
Kubo Hidefumi
Nishiyama Mituo
Kijima Taiki
Tada Kosuke
Miyahara Makoto
About This Article
Descriptions
今回われわれは十二指腸と瘻孔を形成した結核性腹部大動脈瘤のまれな１例を経験したので若干の文献的な考察を加えて報告する.症例は63歳の男性で,肺結核の既往はなし.大量の吐下血にて発症し,当院緊急入院した.十二指腸水平脚部からの出血を認め,腹部CTで嚢状腹部大動脈瘤を指摘された.その後,消化管出血によるショックに陥ったため緊急手術となり,人工血管置換術を施行した.術後病理診断で結核性大動脈瘤と診断された.術後,肺結核に準じた化学療法を投与していたが,術後約40日目に大量吐血を来して再入院となり,出血性ショックで死亡した.原因不明の突然の消化管出血では動脈瘤と消化管の瘻孔も疑うべきであり,活動性の結核病変が無くても仮性動脈瘤の原因として結核は考慮に入れるべき疾患の一つである.
Creator Keywords
Tuberculous aneurysm of Aorta
Aortoduodenal fistula
Hematoemesis
Other Article
PP. 225 - 230