真性胸部大動脈瘤より生じた急性大動脈解離の1例

A Case of Acute Aortic Dissection Originating in a Thoracic Aortic Aneurysm in a Nonagenarian

　真性胸部大動脈瘤より生じた血栓閉鎖型大動脈解離の1例を経験した．症例は93歳，男性．胸背部痛で発症した．症状出現後4日目に施行した胸部CT検査で，上行大動脈から弓部にかけて最大径約70mmの大動脈瘤と瘤の末梢より解離が始まる血栓閉鎖型大動脈解離を認めた．超高齢者であったため外科的治療は行わなかったが，大動脈解離発症後約3カ月後に再検した胸部CT検査で解離腔は狭小化を認めた．現在まで特別な合併症もなく経過している．

We describe a case of a 93-year-old man with acute aortic dissection originating in thoracic aortic aneur-ysm. He experienced sudden onset of severe chest and back pains. Chest computed tomography performed on the 4th day after the onset of the symptoms revealed athoracic aortic aneurysm of 70mm in diameter, and Stanford Type B aortic dissection which arose from the distal end of the aneurysm. This aortic dissection had a thrombus-filled false channel. He was treated medically, and a favorable condition continued. On follow-up chest computed tomography performed 3 months after the onset, non-opacified false lumen had decreased in size.