Dissetion of Superior Mesenteric Artery which Required resection of a Large Amount of the Small Intestine and the Colon : A Case Report
スポンサーリンク
概要
- 論文の詳細を見る
Superior mesenteric artery (SMA) dissection is rare. We herein report about a case of SMA dissection which required resection of a large amount of the small intestine and the colon. A 59-year-old male with vague lower abdominal pain and diarrhea was admitted to our hospital. An erect abdominal X-ray showed niveau. His condition deteriorated and on the fifth day from the onset, an enhanced computed tomography (CT) revealed the SMA was dissected along 3 cm of its length from its origin, and the blood supply to the small intestine was shuttered in association with false lumen formation. Finally, the patient was necessitated an emergency surgery. A grayish ischemic small intestine and ascending colon were seen along with a moderate amount of ascites. The ischemic part of the intestine was resected. Pathological findings revealed coagulation necrosis with inflammatory cell infiltration, blood congestion, and hemorrhage. This coagulation necrosis was compatible with hemorrhagic necrosis due to intestinal ischemia. In conclusion, enhanced CT was available for detecting SMA dissection. If a patient with acute abdomen of unknown origin is encountered, SMA dissection should be ruled out, because ischemic intestine due to SMA occlusion is time-dependent and life-threatening. Furthermore, in the case of extensive bowel resection, the management of short bowel syndrome is thought to be essential.
- 北関東医学会の論文
著者
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Nakamura Tetsuya
Department Of Medicine And Biological Science Gunma University Graduate School Of Medicine
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Takahashi Shinji
Department of Regional Management, Tohoku Gakuin University
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Kawagoe Kei
Department of Gastroenterology, Kanto Medical Center NTT EC
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UEYAMA Yoshito
Department of Pathology, School of Medicine, Tokai University
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Kurihara Eiji
Department Of Neuropediatrics Tokyo Metropolitan Neurological Hospital
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Kobayashi Naoyuki
Department Of Surgery Inagi Municipal Hospital
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Kobayashi Naoyuki
Department Of Sobudai Nieren Clinic Kitasato University School Of Medicine
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Kobayashi Naouki
Department of Surgery
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Saito Junichi
Department of Surgery
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Sagae Santaro
Department of Surgery
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Iwata Kenji
Department of Surgery
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Ikeda Toshiaki
Department of Radiology
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Saito Mitsuhiro
Department of Internal Medicine, Inagi Municipal Hospital
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Horikawa Hitomi
Department of Internal Medicine, Inagi Municipal Hospital
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Muto Hidetomo
Department of Internal Medicine, Inagi Municipal Hospital
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Kou Kinsei
Department of Internal Medicine, Inagi Municipal Hospital
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Ohgino Yasuyuki
Department of Internal Medicine, Inagi Municipal Hospital
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Okukubo Lisa
Department of Internal Medicine, Inagi Municipal Hospital
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Ueyama Yoshito
Department Of Pathology School Of Medicine Tokai University
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Saito Junichi
Department Of Radiology Maebashi Red Cross Hospital
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Ikeda Toshiaki
Department Of Chemistry Graduate School Of Science Kyoto University
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Horikawa Hitomi
Department Of Internal Medicine School Of Medicine Keio University
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Nakamura Tetsuya
Department Of Infectious Disease And Applied Immunology The Institute Of Medical Science The Univers
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Takahashi Shinji
Department Of Anesthesia And Critical Care Medicine Tsukuba Gakuen Hospital
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Kou Kinsei
Department Of Internal Medicine Keio University School Of Medicine
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Saito Junichi
Department Of Anesthesiology Hirosaki University Graduate School Of Medicine
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Nakamura Tetsuya
Department Of Endoscopy Dokkyo University School Of Medicine
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UEYAMA Yoshito
Department of Dermatology, Division of Specialized Clinical Science, Tokai University School of Medicine
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Ueyama Yoshito
Department of Pathology
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Ohgino Yasuyuki
Department of Cardiology, Keio University
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Iwata Kenji
Department of Chemical Engineering, The University of Tokyo
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Kobayashi Naoyuki
Department of Judo Physical Therapy, Faculty of Regional Health Therapy, Teikyo Heisei University
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