日本救急医学会雑誌
Online ISSN : 1883-3772
Print ISSN : 0915-924X
ISSN-L : 0915-924X
胸腹部銃創の1救命例
吉田 昌弘鴻巣 寛久保 速三吉井 一博志馬 伸朗白方 秀二
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1996 年 7 巻 11 号 p. 720-724

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The patient, a 51-year-old male, suffered from two gunshot injuries in the right chest and abdomen. Computed tomography (CT) revealed right hemothorax, pulmonary trauma, hepatic, pancreatic, duodenal and transverse colic injury and postcaval trauma. An emergency operation was performed to repair these injured parts. During surgery, there was massive bleeding from the injured inferior vena cava. Duration of the surgery was 8.5hr and blood loss was 8, 000ml. Massive bleeding due to leakage of pancreatic juice occurred 23 days after surgery. A superior mesenteric angiogram showed extravasation from the right branch of the middle colic artery. Transcatheter arterial embolization (TAE) was successfully performed by using gelatin sponge. The patient was discharged on the 120th postoperative day. Preoperative CT was helpful in diagnosing trauma from the gunshot injuries. After surgery, TAE was useful for postoperative bleeding. We suspect that the gunshot injuries caused the pseudo aneurysm.
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