脳動脈瘤術後消化管出血

Gastrointestinal Bleeding in Cases of Ruptured Cerebral Aneurysms

Ⅰ．はじめに

　脳疾患に併発する消化管出血はCushing ulcerとも呼ばれ，一般に予後不良を示している．

　さて現在迄高血圧性脳出血の際の消化管出血に関しての報告は多いが，一方破裂脳動脈瘤の際に発生する消化管出血に関する報告は少ない．今回は自験1,000例の嚢状動脈瘤の直接手術例を母集団として，消化管出血を合併した症例について，術後重症度，手術所見などの臨床的見地から種々検討した．

Among the 1,000 cases of direct surgery on cerebral aneurysms, two cases showed clear signs of preoperative and 19 cases showed postoperative gastrointestinal bleeding. Here we have made a clinical analysis of various aspects of the 19 cases in which the bleeding developed postoperatively.

(1) Gastrointestinal bleeding was most frequent postoperatively in cases of VBA aneurysms (4.3%) and AcomA aneurysms (2.9%) and less common in MCA and ACA aneurysm cases.