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英文誌(2004-)

Journal of Medical Ultrasonics

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1994 - Vol.21

Vol.21 No.08

Case Report(症例報告)

(0530 - 0535)

横隔膜破裂の1例

A Case Report of Rupture of the Diaphragm

浜崎 直樹1, 川崎 恭1, 須崎 康恵1, 江川 信一1, 鴻池 義純1, 龍神 良忠1, 仲川 房幸2, 今井 幸子3, 大石 元4, 成田 亘啓5

Naoki HAMAZAKI1, Kyou KAWASAKI1, Yasue SUZAKI1, Shinichi EGAWA1, Yoshizumi KOUNOIKE1, Yoshitada RYUUJIN1, Fusayuki NAKAGAWA2, Yukiko IMAI3, Hajime OHISHI4, Nobuhiro NARITA5

1済生会奈良病院内科, 2済生会奈良病院放射線科, 3奈良県立五条病院放射線科, 4奈良県立医科大学腫瘍放射線科, 5奈良県立医科大学第2内科

1Department of Internal Medicine Saiseikai Nara Hospital, 2Department of Radiology Saiseikai Nara Hospital, 3Department of Radiology, Nara Prefectural Gojo Hospital, 4Department of Oncoradiology, Nara Medical University, 5The second Department of Internal Medicine, Nara Medical University

キーワード : Rupture of the diaphragm, Ultrasonography, Lung cancer, Adrenal metastasis

The patient, a 57-year-old male diagnosed with lung cancer at another hospital, consulted our hospital complaining of abdominal pain. Diagnostic imaging revealed an adrenal metastasis, 8 cm in size. To treat this metastasis, TAE was administered three times. Twenty days after the third TAE treatment, the patient complained of sudden epigastric pain and hematemesis. A chest radiograph revealed a large cavity in the left lung field and ultrasonography indicated a large quantity of fluid in the left pleural cavity. Real-time observation of the chest region by ultrasonography revealed air bubbles arising steadily from the lower portions of the liquid in the pleural cavity. This findings suggested that the pleural cavity was in anatomical communication with the digestive tract. Gastric fluoroscopy and CT scanning showed prolapse of the stomach into the pleural cavity. The prolapse was thought to be due to rupture of the diaphragm.