小児脾損傷に伴う脾仮性動脈瘤に対する選択的動脈塞栓術 : 自験３例からの考察
脾外傷に対する非手術療法の合併症である遅発性出血には脾仮性動脈瘤の重要性が指摘されているが, 小児例における治療的アプローチは明らかでない. 今回, 異なる臨床経過を呈した３小児例を経験したので報告する. 症例１ : 受傷時に仮性動脈瘤は認めず, 第２病日の遅発性出血時に診断し塞栓術を施行した. 症例２ : 受傷時に認めた仮性瘤が第３病日までに急速に増大し, 塞栓術を施行した. 症例３ : 第８病日に診断した仮性瘤の第13病日における消失を認めた. 小児脾損傷に対する非手術的治療における血管損傷の経時的評価は必須であり, 仮性瘤を疑う所見があれば, 成人と同様に積極的な選択的脾動脈塞栓術を考慮...
Saved in:
| Published in | Journal of the Japanese Association for the Surgery of Trauma Vol. 31; no. 3; pp. 400 - 404 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本外傷学会
2017
The Japanese Association for the Surgery of Trauma |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1340-6264 2188-0190 |
| DOI | 10.11382/jjast.31.400 |
Cover
| Abstract | 脾外傷に対する非手術療法の合併症である遅発性出血には脾仮性動脈瘤の重要性が指摘されているが, 小児例における治療的アプローチは明らかでない. 今回, 異なる臨床経過を呈した３小児例を経験したので報告する. 症例１ : 受傷時に仮性動脈瘤は認めず, 第２病日の遅発性出血時に診断し塞栓術を施行した. 症例２ : 受傷時に認めた仮性瘤が第３病日までに急速に増大し, 塞栓術を施行した. 症例３ : 第８病日に診断した仮性瘤の第13病日における消失を認めた. 小児脾損傷に対する非手術的治療における血管損傷の経時的評価は必須であり, 仮性瘤を疑う所見があれば, 成人と同様に積極的な選択的脾動脈塞栓術を考慮すべきであると考える. |
|---|---|
| AbstractList | 脾外傷に対する非手術療法の合併症である遅発性出血には脾仮性動脈瘤の重要性が指摘されているが, 小児例における治療的アプローチは明らかでない. 今回, 異なる臨床経過を呈した３小児例を経験したので報告する. 症例１ : 受傷時に仮性動脈瘤は認めず, 第２病日の遅発性出血時に診断し塞栓術を施行した. 症例２ : 受傷時に認めた仮性瘤が第３病日までに急速に増大し, 塞栓術を施行した. 症例３ : 第８病日に診断した仮性瘤の第13病日における消失を認めた. 小児脾損傷に対する非手術的治療における血管損傷の経時的評価は必須であり, 仮性瘤を疑う所見があれば, 成人と同様に積極的な選択的脾動脈塞栓術を考慮すべきであると考える. Delayed hemorrhage is a serious complication of non-operative management in patients with splenic injury. Although splenic artery pseudoaneurysm has been suggested to be involved in this condition, the therapeutic approach in children is not clear. We report three cases with different clinical courses. Case 1 : No pseudoaneurysm was demonstrated at the time of admission. However, delayed bleeding occurred and pseudoaneurysm was evident on day 2 after injury, which was embolized. Case 2 : A pseudoaneurysm presented on admission was rapidly enlarged on day 3 after injury, for which embolization was performed. Case 3 : A pseudoaneurysm was diagnosed on the 8th day, which disappeared on angiography on the 13th day. Serial evaluation of vascular injury is essential in non-operative management for pediatric trauma patients with splenic injury. Selective splenic artery embolization should be considered for any pseudoaneurysm, even in pediatric trauma patients. 脾外傷に対する非手術療法の合併症である遅発性出血には脾仮性動脈瘤の重要性が指摘されているが, 小児例における治療的アプローチは明らかでない. 今回, 異なる臨床経過を呈した３小児例を経験したので報告する. 症例１ : 受傷時に仮性動脈瘤は認めず, 第２病日の遅発性出血時に診断し塞栓術を施行した. 症例２ : 受傷時に認めた仮性瘤が第３病日までに急速に増大し, 塞栓術を施行した. 症例３ : 第８病日に診断した仮性瘤の第13病日における消失を認めた. 小児脾損傷に対する非手術的治療における血管損傷の経時的評価は必須であり, 仮性瘤を疑う所見があれば, 成人と同様に積極的な選択的脾動脈塞栓術を考慮すべきであると考える. |
| Author | 佐藤, 哲哉 山内, 聡 野村, 亮介 久志本, 成樹 |
| Author_FL | KUSHIMOTO Shigeki 佐藤 哲哉 NOMURA Ryosuke YAMANOUCHI Satoshi |
| Author_FL_xml | – sequence: 1 fullname: 佐藤 哲哉 – sequence: 2 fullname: NOMURA Ryosuke – sequence: 3 fullname: YAMANOUCHI Satoshi – sequence: 4 fullname: KUSHIMOTO Shigeki |
| Author_xml | – sequence: 1 fullname: 山内, 聡 organization: 大崎市民病院救命救急センター – sequence: 1 fullname: 佐藤, 哲哉 organization: 東北大学大学院医学系研究科外科病態学講座救急医学分野 – sequence: 1 fullname: 久志本, 成樹 organization: 東北大学大学院医学系研究科外科病態学講座救急医学分野 – sequence: 1 fullname: 野村, 亮介 organization: 東北大学病院高度救命救急センター |
| BackLink | https://cir.nii.ac.jp/crid/1390001205515438336$$DView record in CiNii |
| BookMark | eNo9kL1Lw0AAxQ9RsNaO7h1cU-9yl7uLi0jxCwouOodrmmpCrZJ0cWtq_SxioQjqUC0IikLrIChY-s-kSdPJf8HUist78H6PN7wZMFncLxoAzCGYQghzecGyhFNKYZQiEE6AmIw4lyBS4SSIIUygRGVKpkHCccwsVDhRMeMsBgr-25V_XA-rvaB-6Vc-PPe133333JMo6X-1g_KTX7sOq2eDm8cI-Z2e5956ldrQ_QwumoO76pj6rWbw0AhbjeRiMjx9GT43vruNfq_muTWvcu657bB85HfuZ8FUXhQcI_HncbC9urKVXpcym2sb6eWMZMlYphInearm9DyFalaHiBmEQkZUWeQoznFCZE5yeYMhrCPGcJYZVBGCGkqWIKwiyHAczI93i6ap6eZIIwIhRDJUFKQQzDGmUW1pXLOcktgxtAPb3BP2oSbskqkXDO33UQ0jDY8kuvWf6LvC1iyBfwD3wpPb |
| ContentType | Journal Article |
| Copyright | 2017 一般社団法人 日本外傷学会 |
| Copyright_xml | – notice: 2017 一般社団法人 日本外傷学会 |
| DBID | RYH |
| DOI | 10.11382/jjast.31.400 |
| DatabaseName | CiNii Complete |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| DocumentTitleAlternate | SELECTIVE ARTERIAL EMBOLIZATION FOR SPLENIC ARTERY PSEUDOANEURYSM IN PEDIATRIC PATIENTS WITH BLUNT SPLENIC INJURY : REPORT OF 3 CASES AND LITERATURE REVIEW |
| DocumentTitle_FL | SELECTIVE ARTERIAL EMBOLIZATION FOR SPLENIC ARTERY PSEUDOANEURYSM IN PEDIATRIC PATIENTS WITH BLUNT SPLENIC INJURY : REPORT OF 3 CASES AND LITERATURE REVIEW |
| EISSN | 2188-0190 |
| EndPage | 404 |
| ExternalDocumentID | 130005815373 article_jjast_31_3_31_400_article_char_ja |
| GroupedDBID | ALMA_UNASSIGNED_HOLDINGS JSF KQ8 RJT RYH |
| ID | FETCH-LOGICAL-j2326-84f69dcf609bc017e4607492ad63d844284dfe713c1773b7e65aa6e5b41391073 |
| ISSN | 1340-6264 |
| IngestDate | Fri Jun 27 00:30:50 EDT 2025 Wed Sep 03 06:29:43 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 3 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2326-84f69dcf609bc017e4607492ad63d844284dfe713c1773b7e65aa6e5b41391073 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jjast/31/3/31_400/_article/-char/ja |
| PageCount | 5 |
| ParticipantIDs | nii_cinii_1390001205515438336 jstage_primary_article_jjast_31_3_31_400_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2017 |
| PublicationDateYYYYMMDD | 2017-01-01 |
| PublicationDate_xml | – year: 2017 text: 2017 |
| PublicationDecade | 2010 |
| PublicationTitle | Journal of the Japanese Association for the Surgery of Trauma |
| PublicationTitleAlternate | 日外傷会誌 |
| PublicationTitle_FL | 日本外傷学会雑誌 日外傷会誌 J. Jpn. Assoc. Surg. Trauma |
| PublicationYear | 2017 |
| Publisher | 一般社団法人 日本外傷学会 The Japanese Association for the Surgery of Trauma |
| Publisher_xml | – name: 一般社団法人 日本外傷学会 – name: The Japanese Association for the Surgery of Trauma |
| References | 3) Davis KA, Fabian TC, Croce MA, et al : Improved success in nonoperative management of blunt splenic injuries : embolization of splenic artery pseudoaneurysms. J Trauma 1998 ; 44 : 1008-1013. 8) Stylianos S and the APSA Liver/Spleen Trauma Study Group : Compliance with Evidence-Based Guidelines for Resource Utilization in Children with Isolated Spleen or Liver Injury : A Prospective Study. J Pediatr Surg 2002 ; 37 : 453-456. 2) Schurr MJ, Fabian TC, Gavant M, et al : Management of blunt splenic trauma : computed tomographic contrast blush predicts failure of nonoperative management. J Trauma 1995 ; 39 : 507-513. 11) Durkin N, Deganello A, Sellars ME, et al : Post-traumatic liver and splenic pseudoaneurysms in children : Diagnosis, management, and follow-up screening using contrast enhanced ultrasound (CEUS). J Pediatr Surg 2016 ; 51 : 289-292. 12) Muroya T, Ogura H, Shimizu K, et al : Delayed formation of splenic pseudoaneurysm following nonoperative management in blunt splenic injury : Multi-institutional study in Osaka, Japan. J Trauma Acute Care Surg 2013 ; 75 : 417-420. 6) 日本外傷学会臓器損傷分類委員会 : 日本外傷学会臓器損傷分類委員会2008 (日本外傷学会). 日本外傷外誌 2008 ; 22 : 262-274. 13) Weinberg JA, Lockhart ME, Parmar AD, et al : Computed Tomography Identification of Latent Pseudoaneurysm after Blunt Splenic Injury : Pathology or Technology?. J Trauma 2010 ; 68 : 1112-1116. 10) Safavi A, Beaudry P, Jamieson D, et al : Traumatic pseudoaneurysms of the liver and spleen in children : is routine screening warranted?. J Pediatr Surg 2011 ; 46 : 938-941. 1) Stassen NA, Bhullar I, Cheng JD, et al : Selective nonoperative management of blunt splenic injury : An Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg 2012 ; 73 : S294-S300. 9) Frumiento C, Sartorelli K, Vane D, et al : Expansion of the Nonoperative Theorem. J Pediatr Surg 2000 ; 35 : 788-791. 4) Zarzaur BL, Kozar RA, Fabian TC, et al : A Survey of American Association for the Surgery of Trauma Member Practices in the Management of Blunt Splenic Injury. J Trauma 2011 ; 70 : 1026-1031. 5) Martin K, VanHouwelingen L, Butter A : The significance of psuedoaneurysms in the nonoperative management of pediatric blunt splenic trauma. J Pediatr Surg 2011 ; 46 : 933-937. 7) Davies DA, Fecteau A, Himidan S, et al : What's the Incidence of Delayed Splenic Bleeding in Children After Blunt Trauma? An Institutional Experience and Review of the Literature. J Trauma 2009 ; 67 : 573-577. |
| References_xml | – reference: 8) Stylianos S and the APSA Liver/Spleen Trauma Study Group : Compliance with Evidence-Based Guidelines for Resource Utilization in Children with Isolated Spleen or Liver Injury : A Prospective Study. J Pediatr Surg 2002 ; 37 : 453-456. – reference: 7) Davies DA, Fecteau A, Himidan S, et al : What's the Incidence of Delayed Splenic Bleeding in Children After Blunt Trauma? An Institutional Experience and Review of the Literature. J Trauma 2009 ; 67 : 573-577. – reference: 13) Weinberg JA, Lockhart ME, Parmar AD, et al : Computed Tomography Identification of Latent Pseudoaneurysm after Blunt Splenic Injury : Pathology or Technology?. J Trauma 2010 ; 68 : 1112-1116. – reference: 11) Durkin N, Deganello A, Sellars ME, et al : Post-traumatic liver and splenic pseudoaneurysms in children : Diagnosis, management, and follow-up screening using contrast enhanced ultrasound (CEUS). J Pediatr Surg 2016 ; 51 : 289-292. – reference: 2) Schurr MJ, Fabian TC, Gavant M, et al : Management of blunt splenic trauma : computed tomographic contrast blush predicts failure of nonoperative management. J Trauma 1995 ; 39 : 507-513. – reference: 1) Stassen NA, Bhullar I, Cheng JD, et al : Selective nonoperative management of blunt splenic injury : An Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg 2012 ; 73 : S294-S300. – reference: 12) Muroya T, Ogura H, Shimizu K, et al : Delayed formation of splenic pseudoaneurysm following nonoperative management in blunt splenic injury : Multi-institutional study in Osaka, Japan. J Trauma Acute Care Surg 2013 ; 75 : 417-420. – reference: 10) Safavi A, Beaudry P, Jamieson D, et al : Traumatic pseudoaneurysms of the liver and spleen in children : is routine screening warranted?. J Pediatr Surg 2011 ; 46 : 938-941. – reference: 5) Martin K, VanHouwelingen L, Butter A : The significance of psuedoaneurysms in the nonoperative management of pediatric blunt splenic trauma. J Pediatr Surg 2011 ; 46 : 933-937. – reference: 4) Zarzaur BL, Kozar RA, Fabian TC, et al : A Survey of American Association for the Surgery of Trauma Member Practices in the Management of Blunt Splenic Injury. J Trauma 2011 ; 70 : 1026-1031. – reference: 6) 日本外傷学会臓器損傷分類委員会 : 日本外傷学会臓器損傷分類委員会2008 (日本外傷学会). 日本外傷外誌 2008 ; 22 : 262-274. – reference: 9) Frumiento C, Sartorelli K, Vane D, et al : Expansion of the Nonoperative Theorem. J Pediatr Surg 2000 ; 35 : 788-791. – reference: 3) Davis KA, Fabian TC, Croce MA, et al : Improved success in nonoperative management of blunt splenic injuries : embolization of splenic artery pseudoaneurysms. J Trauma 1998 ; 44 : 1008-1013. |
| SSID | ssib058493787 ssib002003913 ssib029852148 ssj0003306068 |
| Score | 2.0859678 |
| Snippet | 脾外傷に対する非手術療法の合併症である遅発性出血には脾仮性動脈瘤の重要性が指摘されているが, 小児例における治療的アプローチは明らかでない. 今回, 異なる臨床経... Delayed hemorrhage is a serious complication of non-operative management in patients with splenic injury. Although splenic artery pseudoaneurysm has been... |
| SourceID | nii jstage |
| SourceType | Publisher |
| StartPage | 400 |
| SubjectTerms | pediatric trauma splenic artery pseudoaneurysm splenic injury 小児外傷 脾仮性動脈瘤 脾損傷 |
| Title | 小児脾損傷に伴う脾仮性動脈瘤に対する選択的動脈塞栓術 : 自験３例からの考察 |
| URI | https://www.jstage.jst.go.jp/article/jjast/31/3/31_400/_article/-char/ja https://cir.nii.ac.jp/crid/1390001205515438336 |
| Volume | 31 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本外傷学会雑誌, 2017/07/20, Vol.31(3), pp.400-404 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 2188-0190 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0003306068 issn: 1340-6264 databaseCode: KQ8 dateStart: 20140101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnR1daxNB8Gjriy-iqFhrpQ_uU0m9u93b2_VtL71S-qBIW-hbuEsu0CBVbPqgT02tn0UsFEF9qBYERaH1QVCw9M-kadMn_4Izc5f0igU_ICyX2Z3Z2Zm5zMxmPyzrSpQoVRZJXHCkdgvCj6OCqsS6EIG3EF7Fd3lMC2Svy_FpMTHjzfT0DeRWLS3U45Hy_WP3lfyPVgEGesVdsv-g2S5RAMAz6BdK0DCUf6VjFnossJkawwflMW2zUDElWBCyUOJXNUpVLgt8FnIIG5kJWAgNiiwQGUTJHBaUATOErmxmfEIPmPayNkqx0GdaMSNyBD1mxgidIFrTg4uIoUZIoIigYTokdIOkjqEMdBxqI5mxmeZYhRBOMxfU0GfGIFWjqH4Mh4IPxD52mI4p6LCgO2yGhA4i4Rm_-siSxlxkjrH4BAQReDln3n67SzIn073k2BZ8_cKha5s0UzeGp5L6_MK9LoxE4DOVqmSUaWeYuDXEEslbBYeNQaMOflA6IDIvHTXw7xy2ASSN-sbGMA6fKBeZKQ6TmBUZgkQRBTo_rZPuX6VXkIiQPJA8SLmIijGpEYAlgRFwpBFw0hDxGxiiD_0Zr9slCVMwLXOGBpBRZmRmaNrkPB_HfSBueqT8SEIwCP9wpWN6n2vHXWZOezY_m0K-T9h2LowS6a3Sv3torvDI31otmq-PcGeki3Xk0HP8k9X2FLhjn_daJ1ycbMMVFzdzuTFdbtB1Lq5WEIke5vYQWEPkneUeGJZxSI7tdGtsZ6idM3eBpat5hiAarUFuhodu9M7NzuYCzqnT1qnMHodM-tqfsXpq0VnrVuvLi9bD1fbyzt7q89bSt2bj8-7212bjEUB2f2zuLX5orbxsLz_Zf_UeqlpbO83G6-bSykHj-96z9f03y2lta2N9791ae2Nt6NpQ-_Gng49rP7fXdndWmo2V5tLTZmOzvfigtfX2nDU9Fk4VxwvZhSmFGiRGsqBEVepKuSptHZfBphIhIUPQblSRvKKEgFC0Uk18h5cd3-exn0gvimTixRDJQtrg8_NW39ztueSCNVTGc0HLyhfwcy0qdlVDrK9lFFUhIBE6cfstlYqodCc9FaeU_QqWSJAl7pQ4FiDNbg3uIy3Von5rEIRaKs9iCR3TZLgNmZuHxyZzefEP9QPWSXxh0nnQS1Zf_e5CMgiZQT2-TBbyCwMB4D4 |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E5%B0%8F%E5%85%90%E8%84%BE%E6%90%8D%E5%82%B7%E3%81%AB%E4%BC%B4%E3%81%86%E8%84%BE%E4%BB%AE%E6%80%A7%E5%8B%95%E8%84%88%E7%98%A4%E3%81%AB%E5%AF%BE%E3%81%99%E3%82%8B%E9%81%B8%E6%8A%9E%E7%9A%84%E5%8B%95%E8%84%88%E5%A1%9E%E6%A0%93%E8%A1%93+%3A+%E8%87%AA%E9%A8%93%EF%BC%93%E4%BE%8B%E3%81%8B%E3%82%89%E3%81%AE%E8%80%83%E5%AF%9F&rft.jtitle=Journal+of+the+Japanese+Association+for+the+Surgery+of+Trauma&rft.au=SATO+Tetsuya&rft.au=%E9%87%8E%E6%9D%91+%E4%BA%AE%E4%BB%8B&rft.au=%E5%B1%B1%E5%86%85+%E8%81%A1&rft.au=%E4%B9%85%E5%BF%97%E6%9C%AC+%E6%88%90%E6%A8%B9&rft.date=2017&rft.pub=%E4%B8%80%E8%88%AC%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E5%A4%96%E5%82%B7%E5%AD%A6%E4%BC%9A&rft.issn=1340-6264&rft.eissn=2188-0190&rft.volume=31&rft.issue=3&rft.spage=400&rft.epage=404&rft_id=info:doi/10.11382%2Fjjast.31.400&rft.externalDocID=130005815373 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1340-6264&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1340-6264&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1340-6264&client=summon |