卵巣動脈瘤破裂による後腹膜血腫の1例
症例は40歳代の女性．左側腹部痛と意識消失発作にて発症し，当院に救急搬送された．血管造影にて左卵巣動脈瘤破裂と考えられ，塞栓術を施行した．塞栓術後1カ月目のCTにて後腹膜血腫の増大を認め，外科的なドレナージが必要と考えられたため，後腹膜アプローチにて血腫除去術および止血術を施行し軽快した．卵巣動脈瘤破裂はきわめてまれな疾患であるが，女性の後腹膜血腫をみた場合，本疾患の可能性も念頭に置いて検査を進める必要がある．また塞栓術後に血腫の吸収が遷延する場合には外科的な血腫除去および止血術を積極的に考慮すべきと考えられた．...
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| Published in | 日本臨床外科学会雑誌 Vol. 71; no. 8; pp. 2155 - 2159 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本臨床外科学会
2010
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1345-2843 1882-5133 |
| DOI | 10.3919/jjsa.71.2155 |
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| Abstract | 症例は40歳代の女性．左側腹部痛と意識消失発作にて発症し，当院に救急搬送された．血管造影にて左卵巣動脈瘤破裂と考えられ，塞栓術を施行した．塞栓術後1カ月目のCTにて後腹膜血腫の増大を認め，外科的なドレナージが必要と考えられたため，後腹膜アプローチにて血腫除去術および止血術を施行し軽快した．卵巣動脈瘤破裂はきわめてまれな疾患であるが，女性の後腹膜血腫をみた場合，本疾患の可能性も念頭に置いて検査を進める必要がある．また塞栓術後に血腫の吸収が遷延する場合には外科的な血腫除去および止血術を積極的に考慮すべきと考えられた． |
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| AbstractList | 症例は40歳代の女性．左側腹部痛と意識消失発作にて発症し，当院に救急搬送された．血管造影にて左卵巣動脈瘤破裂と考えられ，塞栓術を施行した．塞栓術後1カ月目のCTにて後腹膜血腫の増大を認め，外科的なドレナージが必要と考えられたため，後腹膜アプローチにて血腫除去術および止血術を施行し軽快した．卵巣動脈瘤破裂はきわめてまれな疾患であるが，女性の後腹膜血腫をみた場合，本疾患の可能性も念頭に置いて検査を進める必要がある．また塞栓術後に血腫の吸収が遷延する場合には外科的な血腫除去および止血術を積極的に考慮すべきと考えられた． |
| Author | 荒田, 尚 重安, 邦俊 竹原, 清人 田中屋, 宏爾 竹内, 仁司 金澤, 卓 |
| Author_xml | – sequence: 1 fullname: 竹原, 清人 organization: 国立病院機構岩国医療センター外科 – sequence: 1 fullname: 荒田, 尚 organization: 国立病院機構岩国医療センター外科 – sequence: 1 fullname: 重安, 邦俊 organization: 国立病院機構岩国医療センター外科 – sequence: 1 fullname: 竹内, 仁司 organization: 国立病院機構岩国医療センター外科 – sequence: 1 fullname: 金澤, 卓 organization: 国立病院機構岩国医療センター外科 – sequence: 1 fullname: 田中屋, 宏爾 organization: 国立病院機構岩国医療センター外科 |
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| References | 17) Nakajo M, Ohkubo K, Fukukura Y, et al : Embolization of spontaneous rupture of an aneurysm of the ovarian artery supplying the uterus with fibroids. Acta Radiol 2005 ; 46 : 887-890 8) Siu KF, Luk SL, Kung TM : Spontaneous rupture of the ovarian artery. J R Coll Surg Edinb 1986 ; 31 : 237-240 20) Poilblanc M, Winer N, Bouvier A, et al : Rupture of an aneurysm of the ovarian artery following delivery and endovascular treatment. Am J Obstet Gynecol 2008 ; 199 : e7-8 9) Hφgdall CK, Pedersen SJ, Ovlisen BO, et al : Spontaneous rupture of an ovarian-artery aneurysm in the third trimester of pregnancy. Acta Obstet Gynecol Scand 1989 ; 68 : 651-652 10) King WL : Ruptured ovarian artery aneurysm : a case report. J Vasc Surg 1990 ; 12 : 190-193 3) Tsoutsoplides GC : Post-partum spontaneous rupture of a branch of the ovarian artery. Scott Med J 1967 ; 12 : 289-290 4) Riley PM : Letter : Rupture of right ovarian artery aneurysm during delivery. S Afr Med J 1975 ; 49 : 729 21) 伊良波裕子，柴田冬樹，蔵下 要他:卵巣動脈破綻が原因と考えられた後腹膜血腫の1例．IVR 2008;23:53-56 13) Blachar A, Bloom AI, Golan G, et al : Case reports. Spiral CT imaging of a ruptured post-partum ovarian artery aneurysm. Clin Radiol 2000 ; 2 : 718-720 19) Tsai MT, Lien WC : Spontaneous rupture of an ovarian artery aneurysm. Am J Obstet Gynecol 2008 ; 200 : e7-9 12) Guillem P, Bondue X, Chambon JP, et al : Spontaneous retroperitoneal hematoma from rupture of an aneurysm of the ovarian artery following delivery. Ann Vasc Surg 1999 ; 13 : 445-448 1) Phillips CK, Lepor H : Spontaneous retroperitoneal hemorrhage caused by segmental arterial mediolysis. Rev Urol 2006 ; 8 : 36-40 23) 山田英里，伊藤充彰，平光志麻他:自然経腟分娩後に発症した卵巣動脈破裂による後腹膜血腫の1例．東海産婦会誌 2009;45:71-75 16) Banas T, Boryczko M, Durzynska-Urbaniec J : Intraperitoneal hemorrhage due to the rupture of right ovarian artery in the second day of puerperium. Ginekol Pol 2004 ; 75 : 729-732 11) Belfort MA, Simon T, Kirshon B, et al : Ruptured ovarian artery aneurysm complicating a term vaginal delivery. South Med J 1993 ; 86 : 1073-1074 6) Jafari K, Saleh I : Postpartum spontaneous rupture of ovarian artery aneurysm. Obstet Gynecol 1977 ; 49 : 493-495 14) Panoskaltsis T, Padwick M, Thomas JM, et al : Spontaneous rupture of ovarian arterial aneurysm in the antenatal period. Acta Obstet Gynecol Scand 2000 ; 79 : 718-719 15) Manabe Y, Yoshioka K, Yanada J : Spontaneous rupture of a dissection of the left ovarian artery. J Med Invest 2002 ; 49 : 182-185 24) Barrett JM, Van Hooydonk JE, Boehm FH : Pregnancy-related rupture of arterial aneurysms. Obstet Gynecol Surv 1982 ; 37 : 557-566 2) Caillouette JC, Owen HW : Postpartum spontaneous rupture of an ovarian-artery aneurysm. Obstet Gynecol 1963 ; 21 : 510-511 5) Burnett RA, Carfrae DC : Spontaneous rupture of ovarian artery aneurysm in the puerperium. Two case reports and a review of the literature. Br J Obstet Gynaecol 1976 ; 83 : 744-750 7) Mojab K, Rodriguez J : Postpartum ovarian artery rupture with retroperitoneal hemorrhage. AJR Am J Roentgenol 1977 ; 128 : 695-696 18) Kale A, Akdeniz N, Erdemoglu M, et al : Spontaneous rupture of the ovarian artery following spontaneous vaginal birth. Saudi Med J 2005 ; 26 : 1826-1827 22) Chao LW, Chen CH : Spontaneous rupture of an ovarian artery aneurysm. Gynecol Obstet Invest 2009 ; 68 : 104-107 |
| References_xml | – reference: 1) Phillips CK, Lepor H : Spontaneous retroperitoneal hemorrhage caused by segmental arterial mediolysis. Rev Urol 2006 ; 8 : 36-40 – reference: 2) Caillouette JC, Owen HW : Postpartum spontaneous rupture of an ovarian-artery aneurysm. Obstet Gynecol 1963 ; 21 : 510-511 – reference: 13) Blachar A, Bloom AI, Golan G, et al : Case reports. Spiral CT imaging of a ruptured post-partum ovarian artery aneurysm. Clin Radiol 2000 ; 2 : 718-720 – reference: 17) Nakajo M, Ohkubo K, Fukukura Y, et al : Embolization of spontaneous rupture of an aneurysm of the ovarian artery supplying the uterus with fibroids. Acta Radiol 2005 ; 46 : 887-890 – reference: 9) Hφgdall CK, Pedersen SJ, Ovlisen BO, et al : Spontaneous rupture of an ovarian-artery aneurysm in the third trimester of pregnancy. Acta Obstet Gynecol Scand 1989 ; 68 : 651-652 – reference: 21) 伊良波裕子，柴田冬樹，蔵下 要他:卵巣動脈破綻が原因と考えられた後腹膜血腫の1例．IVR 2008;23:53-56 – reference: 23) 山田英里，伊藤充彰，平光志麻他:自然経腟分娩後に発症した卵巣動脈破裂による後腹膜血腫の1例．東海産婦会誌 2009;45:71-75 – reference: 5) Burnett RA, Carfrae DC : Spontaneous rupture of ovarian artery aneurysm in the puerperium. Two case reports and a review of the literature. Br J Obstet Gynaecol 1976 ; 83 : 744-750 – reference: 22) Chao LW, Chen CH : Spontaneous rupture of an ovarian artery aneurysm. Gynecol Obstet Invest 2009 ; 68 : 104-107 – reference: 12) Guillem P, Bondue X, Chambon JP, et al : Spontaneous retroperitoneal hematoma from rupture of an aneurysm of the ovarian artery following delivery. Ann Vasc Surg 1999 ; 13 : 445-448 – reference: 11) Belfort MA, Simon T, Kirshon B, et al : Ruptured ovarian artery aneurysm complicating a term vaginal delivery. South Med J 1993 ; 86 : 1073-1074 – reference: 19) Tsai MT, Lien WC : Spontaneous rupture of an ovarian artery aneurysm. Am J Obstet Gynecol 2008 ; 200 : e7-9 – reference: 3) Tsoutsoplides GC : Post-partum spontaneous rupture of a branch of the ovarian artery. Scott Med J 1967 ; 12 : 289-290 – reference: 24) Barrett JM, Van Hooydonk JE, Boehm FH : Pregnancy-related rupture of arterial aneurysms. Obstet Gynecol Surv 1982 ; 37 : 557-566 – reference: 4) Riley PM : Letter : Rupture of right ovarian artery aneurysm during delivery. S Afr Med J 1975 ; 49 : 729 – reference: 16) Banas T, Boryczko M, Durzynska-Urbaniec J : Intraperitoneal hemorrhage due to the rupture of right ovarian artery in the second day of puerperium. Ginekol Pol 2004 ; 75 : 729-732 – reference: 8) Siu KF, Luk SL, Kung TM : Spontaneous rupture of the ovarian artery. J R Coll Surg Edinb 1986 ; 31 : 237-240 – reference: 14) Panoskaltsis T, Padwick M, Thomas JM, et al : Spontaneous rupture of ovarian arterial aneurysm in the antenatal period. Acta Obstet Gynecol Scand 2000 ; 79 : 718-719 – reference: 18) Kale A, Akdeniz N, Erdemoglu M, et al : Spontaneous rupture of the ovarian artery following spontaneous vaginal birth. Saudi Med J 2005 ; 26 : 1826-1827 – reference: 20) Poilblanc M, Winer N, Bouvier A, et al : Rupture of an aneurysm of the ovarian artery following delivery and endovascular treatment. Am J Obstet Gynecol 2008 ; 199 : e7-8 – reference: 10) King WL : Ruptured ovarian artery aneurysm : a case report. J Vasc Surg 1990 ; 12 : 190-193 – reference: 6) Jafari K, Saleh I : Postpartum spontaneous rupture of ovarian artery aneurysm. Obstet Gynecol 1977 ; 49 : 493-495 – reference: 7) Mojab K, Rodriguez J : Postpartum ovarian artery rupture with retroperitoneal hemorrhage. AJR Am J Roentgenol 1977 ; 128 : 695-696 – reference: 15) Manabe Y, Yoshioka K, Yanada J : Spontaneous rupture of a dissection of the left ovarian artery. J Med Invest 2002 ; 49 : 182-185 |
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| Snippet | 症例は40歳代の女性．左側腹部痛と意識消失発作にて発症し，当院に救急搬送された．血管造影にて左卵巣動脈瘤破裂と考えられ，塞栓術を施行した．塞栓術後1カ月目のCTにて... |
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| SubjectTerms | 卵巣動脈瘤 外科治療 後腹膜血腫 |
| Title | 卵巣動脈瘤破裂による後腹膜血腫の1例 |
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