Rh－血液型患者の下垂体腫瘍摘出術中に生じた大量出血に対して緊急画像下治療を施行した1症例

Emergency Interventional Radiology for Massive Bleeding during Endoscopic Skull-Base Surgery in an Rh-negative Patient

要旨

　Rh抗原陰性である50代女性の非機能性下垂体腺腫に対する経鼻的内視鏡下の下垂体腫瘍摘出術の術中に，内頸動脈の損傷による出血を認めた。Rh抗原陰性の血液製剤を可能な限り輸血したが，完全な止血を得られなかったため緊急で右内頸動脈のコイル塞栓を行った。その結果，止血が得られ，神経学的後遺症も見られなかった。

　Bleeding due to injury to the internal carotid artery was observed during endoscopic skull-base surgery conducted to remove a non-functioning pituitary adenoma in a woman in her 50 s who had an Rh antigen-negative blood type. Although as much Rh antigen-negative blood products were transfused as possible, complete hemostasis could not be obtained. Coil embolization of the right internal carotid artery was therefore performed as an emergency radiological intervention. Complete hemostasis was then achieved, and no neurological sequelae were observed.