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題名 | 上腸系膜動脈及腔動脈栓塞:栓塞切除術以保全胃腸= |
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作者 | 陳顯榮; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19850600 |
卷期 | 18:2 1985.06[民74.06] |
頁次 | 頁214-217 |
分類號 | 416.24 |
語文 | chi |
關鍵詞 | 上腸系膜動脈栓塞; 腔動脈栓塞; 栓塞切除術; |
中文摘要 | 上腸系膜動脈及腔動脈栓塞(celiac axis)同時栓塞是非常罕見的。我們曾經驗一病例,經血管攝影檢查證實上腸系膜動脈及腔動脈栓塞,急診開刀發現胃、小腸、右大腸、肝臟和脾織全成灰白色,乃施行上腸系膜動脈及腔動脈栓塞切除術和脾臟切除術;胃腸外觀恢復成粉紅正常色,術後一星期第二次剖腹探查發現胃腸保全,但胆囊壞死及肝左外側小葉壞死,逐將膽囊切除,術後不幸因心肺衰竭、肝衰竭、腦栓塞而死亡。 早期診斷以栓塞切除術治療可挽救胃腸免除大量切除,同時腔動脈栓塞時要考慮做預防性胆囊切除術。 |
英文摘要 | A case of superior mesenteric artery and celiac axis emboli is presented. This 59-year-old male patient, with a past history of rheumatic heart disease, presented with acute abdominal pain. Electrocardiography showed atrial fibrillation. Angiography revealed complete occlusion of the superior mesenteric artery and partial delayed visualization of the hepatic and splenic arteries. Emergent surgery showed that the storhach, small intestine, right colon, liver and spleen all had become grayish-white. Embolectomy of the superior mesenteric artery and celiac axis, and splenctomy were performed. The viscera became pinkish and viable. The condition deteriorated a week later, and a second laparotomy was carried out. Gangrene of gallbladder and infarction of the lateral segment of the liver were found; however, the gastrointestinal tract was viable. Cholecystectomy was done. One month later the patient died of cardiopulmonary failure, liver failure and cerebral embolism. Early diagnosis and treatment by embolectomy can save the gastrointestinal tract from resection. In case of celiac axis embolus, preventive cholecystectomy should be considered. |
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