肺水腫を伴う急性腹部大動脈閉塞症を来した発作性心房細動の1例

A Case of Acute Aortic Occlusion with Lung Edema in a Patient of Paroxysmal Atrial Fibrillation

要旨　患者は73歳，男性．発作性心房細動の既往があり，2004年7月26日，突然の呼吸困難と下腹部から腰部，両下肢にかけての激痛を主訴に救急車で来院．緊急造影CT検査にて急性腹部大動脈閉塞症と診断され，早期に血行再建術が行われた．急性大動脈閉塞症は，MNMS(myonephropathic metabolic syndrome)や腎不全などの合併症のために予後不良の疾患であり，早期診断と治療を必要とする．本例は肺水腫の合併があり，初期診断が難しかったにもかかわらず，早期治療開始にて，後遺症なく完全に社会復帰することができた．

　A 73-year-old male with paroxysmal atrial fibrillation was admitted to Saitama Medical Center with sudden dyspnea and severe pain from the lower abdomen to both lower limbs. Emergent computed tomography revealed acute abdominal aortic occlusion. Immediately, aortic recanalization therapy was performed and he fully recovered without any defect. Acute aortic occlusion often has a poor prognosis because of MNMS(myonephropathic metabolic syndrome) or acute renal failure. In our case, early diagnosis was difficult because of the accompanying lung edema, but the patient was able to recover fully due to early therapy.