腰椎生検後に腰動脈偽性動脈瘤を生じた1例

Pseudoaneurysm of a Lumbar Artery Following a Vertebral Biopsy : Case Report

　抄録：症例は52歳，男性．化膿性脊椎炎の診断のため透視下に椎体針生検術を行ったところ，術後4日目にショック状態を呈し，右腹部膨隆が出現した．腹部CTでは後腹膜血腫を，血管造影では右第4腰動脈偽性動脈瘤を認めたため，塞栓術を行った．しかし，側副血行路による血腫の増大を認めたため，再度塞栓術を行い，血腫は縮小した．

　A 52-year-old man with suppurative spondylitis experienced a sudden drop in blood pressure four days after a vertebral body biopsy and went into shock. Physical examination revealed right abdominal mass and distention. A CT scan demonstrated a right retroperitoneal hematoma, and when arteriography revealed a pseudoaneurysm arising from the right fourth lumbar artery, we embolized the artery. However, a repeat CT scan demonstrated expansion of the hematoma due to collateral perfusion from the right third lumbar artery to pseudoaneurysm and from iliolumbar artery to pseudoaneurysm embolization of the collateral pathway was performed, and the hematoma decreased in size.