糖尿病性壊疽の1例

A CASE OF DIABETIC GANGRENE

I．緒　言

　動脈の内腔閉塞，または狭窄が原因して，四肢，特に，下肢末梢部に乏血を起こさせ，ひいては壊疽を発生させる疾患は多数ある。それらは，初めから閉塞性の形をとるものもあるが，血管の機能的障害を長期にわたり繰り返えす中に，動脈壁の肥厚，血栓などを生ずる場合もあり，動脈の閉塞の機序・形態は，その原因によつて種々であろう。

　我々は，18歳にして発病した若年性重症糖尿病で，各種の糖尿病合併症をもつた35歳の女性の，左踵やや内側の化膿性壊死部の組織片について，特にその血管の変化を検索して，その中・小動脈に特有な変化を認めたので報告する。

A 35-year-old female in-patient of diabetes mellitus, was first seen in our clinic on June 4, 1964. She had developed various kinds of diabetic complications, such as renal papillary necrosis, multiple neuritis, cataract, and soforth.

Her mother had also been a diabetic, and died of uremia.

Since two months before first examination, this patient had had a bullous eruption on the inner aspect of the left heel, which had been treated as burn by a physician. In spite of the treatment, it was aggravated into a widish deep necrotic lesion, and was complicated by pathological fracture of the heel bone.