弓部大動脈置換術後周術期に合併した内ヘルニアによる腸管壊死の1例

Internal Hernia Accompanying Intestinal Necrosis after Aortic Arch Replacement：Report of a Case

はじめに　開心術後の腸管壊死合併症はまれではあるが，きわめて予後不良である．われわれは，全弓部大動脈置換術後の周術期に開腹歴のない絞扼性腸閉塞による腸管壊死合併例を経験したので報告する．

A 76-year-old man with thoracic aortic aneurysm was admitted to our hospital. Aortic arch replacement was performed uneventfully. He suffered from abdominal pain 17 days after the operation. Computed tomography （CT） scan revealed a strangulated bowel obstruction, and we performed emergent open abdominal surgery. During the operation, we found an adhesion between the greater omentum and the retroperitoneum. The small intestine was intussuscepted into this site, and strangulated with necrosis of a 35-cm length. We performed a partial resection of the small intestine. We encountered rare strangulated bowel obstruction after open heart surgery due to adhesion of the great omentum in a patient without a history of abdominal surgery.