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Neurological Surgery No Shinkei Geka Volume 47, Issue 5 （May 2019）

Neurological Surgery 脳神経外科 47巻5号（2019年5月発行）

Japanese English

症例

未破裂脳動脈瘤治療後に食道粘膜下血腫を来した3症例 Three Cases of Esophageal Submucosal Hematoma after Coiling for Unruptured Cerebral or Intracranial Aneurysms 藤井隆司 ¹ , 大石英則 ^1,2 , 原厚子 ³ , 寺西功輔 ² , 矢富謙治 ² , 山本宗孝 ² Takashi FUJII ¹ , Hidenori OISHI ^1,2 , Atsuko HARA ³ , Kosuke TERANISHI ² , Kenji YATOMI ² , Munetaka YAMAMOTO ² ¹順天堂大学医学部脳神経血管内治療学講座 ²順天堂大学大学院医学研究科脳神経外科講座 ³順天堂大学医学部麻酔科学講座 ¹Department of Neuroendovascular Therapy, Juntendo University Faculty of Medicine ²Department of Neurosurgery, Juntendo University Faculty of Medicine ³Department of Anesthesiology, Juntendo University Faculty of Medicine キーワード： esophageal submucosal hematoma , intracranial aneurysm , coiling , stent assist , antiplatelet Keyword: esophageal submucosal hematoma , intracranial aneurysm , coiling , stent assist , antiplatelet pp.551-558

発行日 2019年5月10日 Published Date 2019/5/10

DOI https://doi.org/10.11477/mf.1436203980

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Ⅰ．緒　　言

　食道粘膜下血腫は，飲食物や胃管などの機械的損傷によるもの，あるいは抗血栓療法による特発性損傷に分けられる，比較的稀な疾患である．今回われわれは，未破裂脳動脈瘤術後に食道粘膜下血腫を来した3症例を経験したため，文献的考察を加えて報告する．

　We report three cases of esophageal submucosal hematoma after treatment of unruptured intracranial aneurysms. All cases were in women with a mean age of 67.7 years. They were administered anti-platelet drugs before undergoing operations to deliver stents. All cases were administered general heparinization during the operation. All three cases developed sudden-onset hemoptysis or epigastric pain. The medical treatments included the temporary cessation or reduction of antiplatelet therapy and all cases were discharged with symptom cure and with the appearance of gastric intestinal fiber on computed tomography imaging. Esophageal submucosal hematoma has a good prognosis with medical therapy. We should consider the potential for esophageal submucosal hematoma after hemoptysis or epigastric pain after coiling of unruptured intracranial aneurysms that require antiplatelet or anticoagulant therapies.