日本救急医学会雑誌
Online ISSN : 1883-3772
Print ISSN : 0915-924X
ISSN-L : 0915-924X
鈍的脾損傷における脾温存術後に発症した遅発性脾破裂の1例
脾内仮性動脈瘤の臨床的意義
北岸 英樹高橋 均丸山 次郎福西 健至丸山 克之松島 知秀坂田 育弘
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1998 年 9 巻 11 号 p. 595-599

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We report a case of a delayed splenic rupture secondary to the rupture of intrasplenic pseudoaneurysm in a 22-year-old man. The patient was hospitalized for blunt splenic injury after sustaing an abdominal trauma in a motorcycle accident. He underwent surgery, in which the spleen was preserved by using an absorbable polyglycolic acid mesh wrap. Postoperative abdominal ultrasonography revealed an aechoic area within the spleen. Doppler velocimetry showed arterial blood flow, and an intrasplenic pseudoaneurysm was suspected. Subsequently a definitive diagnosis of intrasplenic pseudoaneurysm was made by abdominal MRI and abdominal angiography. On the 29th day, the patient suddenly developed abdominal pain and collapsed. Emergency laparotomy was performed and splenectomy was carried out. The diagnosis of ruptured intrasplenic pseudoaneurysm was made based on the intraoperative findings. In conclusion, we advocated that transcatheter arterial embolization should be performed immediately when an intrasplenic pseudoaneurysm is found after blunt splenic injury.

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