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英文誌(2004-)

Journal of Medical Ultrasonics

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1993 - Vol.20

Vol.20 No.10

Case Report(症例報告)

(0602 - 0607)

超音波検査により術前診断し得た上腸間膜動脈閉塞症の1例−超音波ドプラ法による血行動態の観察−

A Case Report of Superior Mesenteric Arterial Occlusion Diagnosed by Doppler Ultrasonography

仲原 正明1, 藤田 修弘1, 中尾 量保1, 荻野 信夫1, 西田 俊朗1, 宮崎 知1, 中村 順一1, 脇 英彦2

Masaaki NAKAHARA1, Nobuhiro FUJITA1, Kazuyasu NAKAO1, Nobuo OGINO1, Toshirou NISHIDA1, Satoru MIYAZAKI1, Jun-ichi NAKAMURA1, Hidehiko WAKI2

1大阪警察病院救急外科,外科,, 2大阪警察病院研究検査科

1Department of Emergency and Clitical Care Medicine, Surgery Osaka Police Hospital, 2US Laboratory Osaka Police Hospital

キーワード : Superior Mesenteric Arterial Occulsion, Ultrasonography, Doppler Flowmetry, Cardiac Output, Portal Flow

A case of superior mesenteric artery (SMA) occlusion diagnosed by Doppler Ultrasonography was reported. A 75-year-old woman suffering abdominal pain was admitted to our emergency medicine. Physical examination revealed a little tenderness on lower abdomen, and serum level of CPK increased to 140 U/l. Ultrasonographic examination showed high echoic lesion in the origin of SMA. The flow volume of portal vein and SMA, measured by Doppler ultrasonography, showed a considerable decrease to 0.12 and 0.05 l/min, respectively. The ratio of portal flow to cardiac output was 0.034. These data strongly suggested occulsion of SMA. A subsequent superior mesenteric arteriography comfirmed complete obstruction at 3.7 cm from its origin. Embolectomy with a Fogarty catheter and partial resection of ileum were performed in an emergency operation within 3 hours after the ultrasonographic examination. Thus Doppler ultrasonography is useful in an early and non-invasive diagnosis of SMA occulusion.