感染性心内膜炎に対する僧帽弁置換術後に併発した感染性左結腸動脈瘤に対し切除術を行った1 例
要旨：感染性心内膜炎に合併した感染性左結腸動脈瘤の報告は稀である．80 歳女性．左片麻痺と発熱で，脳梗塞と診断された．心エコー検査にて僧帽弁閉鎖不全症と僧帽弁両尖に可動性のある疣贅を認め，感染性心内膜炎と診断した．僧帽弁置換術を緊急に行い，抗生剤を継続していたが，発熱が続いた．CT にて下腸間膜動脈領域の動脈瘤を認め，経時的に急速な増大傾向を示したため，感染性動脈瘤と診断し，さらに，大腸癌も合併していたため，同時手術を行った．...
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| Published in | Japanese Journal of Vascular Surgery Vol. 24; no. 5; pp. 836 - 840 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本血管外科学会
2015
日本血管外科学会 JAPANESE SOCIETY FOR VASCULAR SURGERY |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0918-6778 1881-767X |
| DOI | 10.11401/jsvs.15-00001 |
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| Abstract | 要旨：感染性心内膜炎に合併した感染性左結腸動脈瘤の報告は稀である．80 歳女性．左片麻痺と発熱で，脳梗塞と診断された．心エコー検査にて僧帽弁閉鎖不全症と僧帽弁両尖に可動性のある疣贅を認め，感染性心内膜炎と診断した．僧帽弁置換術を緊急に行い，抗生剤を継続していたが，発熱が続いた．CT にて下腸間膜動脈領域の動脈瘤を認め，経時的に急速な増大傾向を示したため，感染性動脈瘤と診断し，さらに，大腸癌も合併していたため，同時手術を行った． |
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| AbstractList | 要旨：感染性心内膜炎に合併した感染性左結腸動脈瘤の報告は稀である．80 歳女性．左片麻痺と発熱で，脳梗塞と診断された．心エコー検査にて僧帽弁閉鎖不全症と僧帽弁両尖に可動性のある疣贅を認め，感染性心内膜炎と診断した．僧帽弁置換術を緊急に行い，抗生剤を継続していたが，発熱が続いた．CT にて下腸間膜動脈領域の動脈瘤を認め，経時的に急速な増大傾向を示したため，感染性動脈瘤と診断し，さらに，大腸癌も合併していたため，同時手術を行った． 「要旨」:感染性心内膜炎に合併した感染性左結腸動脈瘤の報告は稀である. 80歳女性. 左片麻痺と発熱で, 脳梗塞と診断された. 心エコー検査にて僧帽弁閉鎖不全症と僧帽弁両尖に可動性のある疣贅を認め, 感染性心内膜炎と診断した. 僧帽弁置換術を緊急に行い, 抗生剤を継続していたが, 発熱が続いた. CTにて下腸間膜動脈領域の動脈瘤を認め, 経時的に急速な増大傾向を示したため, 感染性動脈瘤と診断し, さらに, 大腸癌も合併していたため, 同時手術を行った. Infective endocarditis complicated by an infected aneurysm at the left colic artery in a patient with colon cancer has rarely been reported. An 80-year-old woman suffered from hemiplegia and high fever. Brain magnetic resonance image confirmed fresh cerebral infarction. An echocardiogram revealed severe mitral regurgitation with floating vegetations attached to both anterior and posterior mitral leaflets. Large vegetations enforced us to perform urgent mitral valve replacement. A blood culture grew no bacteria. Appetite loss and low grade fever continued after mitral valve replacement. Computed tomography identified a 5×3 cm infected aneurysm at the left colic artery and colon cancer. The patient accordingly underwent surgical resection of the infected arterial aneurysm and simultaneous ileocecal resection. Postoperative course was uneventful with no fever and regaining appetite. 要旨：感染性心内膜炎に合併した感染性左結腸動脈瘤の報告は稀である．80 歳女性．左片麻痺と発熱で，脳梗塞と診断された．心エコー検査にて僧帽弁閉鎖不全症と僧帽弁両尖に可動性のある疣贅を認め，感染性心内膜炎と診断した．僧帽弁置換術を緊急に行い，抗生剤を継続していたが，発熱が続いた．CT にて下腸間膜動脈領域の動脈瘤を認め，経時的に急速な増大傾向を示したため，感染性動脈瘤と診断し，さらに，大腸癌も合併していたため，同時手術を行った． |
| Author | 若林, 貴志 曽川, 正和 中村, 制士 |
| Author_FL | Sogawa Masakazu Nakamura Norihito Wakabayashi Takashi |
| Author_FL_xml | – sequence: 1 fullname: Nakamura Norihito – sequence: 2 fullname: Wakabayashi Takashi – sequence: 3 fullname: Sogawa Masakazu |
| Author_xml | – sequence: 1 fullname: 曽川, 正和 organization: 新潟県立中央病院心臓血管外科 – sequence: 1 fullname: 若林, 貴志 organization: 新潟県立中央病院心臓血管外科 – sequence: 1 fullname: 中村, 制士 organization: 新潟県立中央病院心臓血管外科 |
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| DocumentTitleAlternate | Resection of Infected Aneurysm at the Left Colic Artery after Mitral Valve Replacement for Infective Endocarditis |
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| References | 2) Kirkwood ML, Knowles M, Modrall JG, et al. Mycotic inferior mesenteric artery aneurysm secondary to native valve endocarditis caused by coagulase-negative Staphylococcus. Ann Vasc Surg 2014;28:1312.e13–1312.e15. 5) Sachdev U, Baril DT, Ellozy SH, et al. Management of aneurysms involving branches of the celiac and superior mesenteric arteries: a comparison of surgical and endovascular therapy. J Vasc Surg 2006;44:718–724. 6) Chirouze C, Patry I, Duval X, et al. Streptococcus bovis/Streptococcus equinus complex fecal carriage, colorectal carcinoma, and infective endocarditis: a new appraisal of a complex connection. Eur J Clin Microbiol Infect Dis 2013;32:1171–1176. 4) Messina LM, Shanley CJ. Visceral artery aneurysms. Surg Clin North Am 1997;77:425–442. 8) Karchmer AW. Braunwald’s Heart Disease. Ziepes DP, Libby P, Bonow RO, Braunwald E, eds. Elsevier Saunders, 2012. 1540–1560. 3) Edogawa S, Shibuya T, Kurose K, et al. Inferior mesenteric artery aneurysm: case report and literature review. Ann Vasc Dis 2013;6:98–101. 7) Shimada Y, Sogawa M, Okada A, et al. A single-stage operation for abdominal aortic aneurysm with concomitant colorectal carcinoma. Ann Thorac Cardiovasc Surg 2005;11:339–342. 10) Huang TY, Tseng HK, Liu CP, et al. Comparison of the clinical manifestations of infective endocarditis between elderly and young patients—a 3-year study. J Microbiol Immunol Infect 2009;42:154–159. 1) Stengel A, Wolferth CC. Mycotic (Bacterial) aneurysms of intravascular origin. Arch Intern Med 1923;31:527–554. 9) Murdoch DR, Corey GR, Hoen B, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med 2009;169:463–473. |
| References_xml | – reference: 9) Murdoch DR, Corey GR, Hoen B, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med 2009;169:463–473. – reference: 10) Huang TY, Tseng HK, Liu CP, et al. Comparison of the clinical manifestations of infective endocarditis between elderly and young patients—a 3-year study. J Microbiol Immunol Infect 2009;42:154–159. – reference: 5) Sachdev U, Baril DT, Ellozy SH, et al. Management of aneurysms involving branches of the celiac and superior mesenteric arteries: a comparison of surgical and endovascular therapy. J Vasc Surg 2006;44:718–724. – reference: 7) Shimada Y, Sogawa M, Okada A, et al. A single-stage operation for abdominal aortic aneurysm with concomitant colorectal carcinoma. Ann Thorac Cardiovasc Surg 2005;11:339–342. – reference: 3) Edogawa S, Shibuya T, Kurose K, et al. Inferior mesenteric artery aneurysm: case report and literature review. Ann Vasc Dis 2013;6:98–101. – reference: 8) Karchmer AW. Braunwald’s Heart Disease. Ziepes DP, Libby P, Bonow RO, Braunwald E, eds. Elsevier Saunders, 2012. 1540–1560. – reference: 4) Messina LM, Shanley CJ. Visceral artery aneurysms. Surg Clin North Am 1997;77:425–442. – reference: 2) Kirkwood ML, Knowles M, Modrall JG, et al. Mycotic inferior mesenteric artery aneurysm secondary to native valve endocarditis caused by coagulase-negative Staphylococcus. Ann Vasc Surg 2014;28:1312.e13–1312.e15. – reference: 6) Chirouze C, Patry I, Duval X, et al. Streptococcus bovis/Streptococcus equinus complex fecal carriage, colorectal carcinoma, and infective endocarditis: a new appraisal of a complex connection. Eur J Clin Microbiol Infect Dis 2013;32:1171–1176. – reference: 1) Stengel A, Wolferth CC. Mycotic (Bacterial) aneurysms of intravascular origin. Arch Intern Med 1923;31:527–554. |
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| Snippet | 要旨：感染性心内膜炎に合併した感染性左結腸動脈瘤の報告は稀である．80 歳女性．左片麻痺と発熱で，脳梗塞と診断された．心エコー検査にて僧帽弁閉鎖不全症と僧帽弁両... 「要旨」:感染性心内膜炎に合併した感染性左結腸動脈瘤の報告は稀である. 80歳女性. 左片麻痺と発熱で, 脳梗塞と診断された. 心エコー検査にて僧帽弁閉鎖不全症と僧帽弁両... Infective endocarditis complicated by an infected aneurysm at the left colic artery in a patient with colon cancer has rarely been reported. An 80-year-old... |
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| SubjectTerms | colon cancer infected arterial aneurysm infective endocarditis 大腸癌 感染性動脈瘤 感染性心内膜炎 |
| Title | 感染性心内膜炎に対する僧帽弁置換術後に併発した感染性左結腸動脈瘤に対し切除術を行った1 例 |
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