異型狭心症発作後に併発した急性胃潰瘍の経過

Courses of Acute Gastric Ulcer Subsequent to Prinzmetal's Angina

症例

　患　者：64歳　男　印刷業

　主　訴：前胸部圧迫感

　既往歴：特記すべきものなし

　家族歴：兄，脳卒中

　現病歴：1977年3月初旬頃より，入浴する午後9時頃，約10分間持続する前胸部圧迫感をきたしていた．1977年3月28日就寝中の午前1時と6時頃，冷汗とともに前胸部圧迫感をきたし，同日午後2時30分本院CCUへ入院した．

　A man aged 64 was admitted to the CCU of our hospital on March 28, 1977, because of a chief complaint of chest pressure. ECG at admission showed ST elevation in all the chest leads, so that he was medically treated with Diltiazem and Propranolol in addition to other therapeutic measures under a diagnosis of prinzmetal's variant form of angina. an AC bypass grafting was done on April 9 of the same year. At 4 a. m. on April 18 a moderate degree of melena was observed with succeeding anemia. Emergency endoscopy on April 22 showed on the posterior wall of the body a thin and long sash-like ulcer with edematous margins as if it had been punched out. Endoscopic findings on May 27, or 35 days after the bleeding, showed a white linear ulcer scar accompanied with slight mucosal convergency. About two years and a month later, or on June 30, 1979, endoscopy showed healing of the ulcer with hardly any traces. In between there were no symptoms and signs of recurrence.