剖検し得た解離性大動脈瘤についての臨床像の検討

The study of the clinical sign on the autopsied dissecting aneurysm

　解離性大動脈瘤は，多彩な臨床症状を呈するため早期診断にてこずることが少なくない。さらに，最近の画像診断の進歩と，国民の高齢化に伴い発生頻度も増加傾向にある。私達は当院の剖検例876例の内，病理学的に証明しえた18例の臨床病態について検討してみた。

We have sometimes experienced the falles which we could not diagnose the dissecting aneurysm be-cause of the variegated symptom. The occurence of the dissecting aneurysm was increasing because of the progress of the diagnostic imaging and the adva-nced age in the nation. So, we studied in our auto-psy of the dissecting aneurysm.

In our 876 autopsies from Jan in 1969 to Aug in 1983. We found out the aortic aneurysm of 38 falles (4.3%) and the dissecting aneurysm of 18 falles (2.1%) by pathological diagnosis. The ruptured type was 9 falles (De-Bakey I type 4, II type 1, X type 4), and the no ruptured type was 9 falles (De-Bakey III type 9) in the dissecting aneurysm of 18 falles. The mean age was 71 y.o. in the ruptured type and 75 y.o. in the no ruptured type, and the ratio in male : female was 4:5 in the ruptured type and 7: 2 in the no ruptured type.

We studied the clinical sign in 18 falles about the past history, the onset of the symptom, the circu-mstances on falling a ill, the time from the onset of the symptom to the admission to the hospital, the status presence on the admission, the laboratory data on the admission, the transient loss of the conscious-ness, the time from the oncet to the death, the direct cause of the death, the circumstances on the death, the painless dissecting aneurysm and the risk factor.

Particularly, we were interesting in that we found the painless aneurysm high frequently in our case.

We stressed it is important that the many infor-mation is accumulated about the clinical sign in the dissecting aneurysm in JAPAN after this.