腹部限局型急性大動脈解離の3例

Three cases of isolated abdominal aortic dissection

腹部限局型大動脈解離の発生率は年間5.1人/100万人^1），大動脈解離全体の1.1～4％とまれである^2）。さらに大動脈解離336例の剖検によると，その内訳がStanford A型86％，B型14％の比率とされている中で，intimal tearの局在については85％が弓部までに存在し，腹部にみられたのは1％にすぎない^3）。今回我々は，腹部限局型の急性大動脈解離を3例経験したので，文献的な考察を交えて報告する。

We report 3 cases of isolated abdominal aortic dissection. The 1st case was presumed to be spontaneous, however, her aortic dissection had abdominal aortic aneurysm. The 2nd case was caused by IgG4-related disease. This dissection occurred after shrinkage of the soft tissue mass around the abdominal aortic wall. The 3rd case was caused by Ehlers-Danlos syndrome. All the cases were thought to be caused by abdominal aortic wall fragility due to each underlying disease.