咽頭より反復大出血を起した頸部動•静脈瘻の治験

概要

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The authors reported a case of 46 yrs. old man, who had experienced repeated massive pharyngeal hemorrhage during the past twenty years. He had received X-ray radiation therapy under the diagnosisof pharyngeal angioma. However, according to the result of clinical investigations including arteriographicexamination, the authors was leading to the following diagnosis: unusual arterio-venous fistula arising from the deep tissue of the nasopharynx. For the purpose of controlling the recurrent hemorrhage, in the first step, the ligation of right external carotid artery was performed. But this procedurehad only a temporary effect and followed by the reapearance of massive hemorrhage.Therefore the authors decided to ligate the right common carotid artery. Before the ligation was performed, the patient had received the excercises to resist against the temporary blocking of the blood stream of common carotid artery with finger pressure. Electroencephalographies were made befor and after the blocking until no change occured by this procedure. After the ligation of right common carotid artery recurrent homorrhage was completely disappeared. The authors reviewed the literature of arterio-venous anastomosis and found that this was an especially unusual and interesting case.