左肺上葉切除後の上腸間膜動脈閉塞症

Superior Mesenteric Artery Embolism following Left Upper Lobectomy for Lung Cancer

左肺上葉切除後の合併症として，脳梗塞などの塞栓症は予後に直結する留意すべき合併症である．われわれは，左上葉肺腺癌に対する左肺上葉切除後に急性腹症を発症し，上腸間膜動脈（SMA）塞栓症と診断して救命しえた1例を経験したので報告する．

We report a case of superior mesenteric artery （SMA） embolism on the seventh day after lung resection. The patient is a 76-year-old woman. She underwent complete thoracoscopic left upper lobectomy and systematic lymph node dissection for adenocarcinoma of the lung. On the seventh postoperative day, the patient suddenly developed severe abdominal pain. Thrombolytic therapy was selected initially under the diagnosis of the SMA occlusion by the embolism. Since the symptoms did not improve after one hour of thrombolysis, we decided to perform a necrotic bowel resection. Postoperative course was uneventful, and the patient was discharged on the 18th day after laparotomy.