経カテーテル動脈塞栓術後殿筋壊死・直腸粘膜壊死・下肢神経障害を起こした骨盤骨折の1例

Pelvic Fracture Associated with Gluteal Necrosis, Rectal Necrosis, and Lower Limb Palsy Following Transcatheter Arterial Embolization. Case Report

　抄録：出血性ショックを伴った骨盤骨折に対して両側内腸骨動脈の経カテーテル動脈塞栓術（以下TAE）を施行後，TAEが関与したと思われる合併症を来した症例を経験した．症例は23歳男性で，バイク事故により骨盤骨折と右下肢の開放性骨折を受傷した．治療経過中右下肢の感染を併発し切断術を施行した．さらに両側殿筋壊死，直腸壊死，左下肢神経障害が発症し，8カ月にわたる入院治療後車椅子での生活となった．TAEは骨盤骨折に有用な治療手段であるが，合併症の発現についても注意が必要である．

　We report a case of pelvic fracture in a 23-year-old man as a result of a motorcycle accident in which several complications developed after transcatheter arterial embolization. Bilateral internal iliac artery embolization was performed because of severe hemorrhagic shock, and the patient developed gluteal necrosis, rectal necrosis, and a neurological deficit in the lower limb. After 8months of hospitalization he was unable to walk and was confined to a wheelchair because of the sequelae. Transcatheter arterial embolization has been used as an effective means of controlling hemorrhage associated with pelvic fractures, but it is important to be aware of these significant complications.