術後呼吸不全を来し筋萎縮性側索硬化症と診断された1症例

Postoperative Respiratory Failure Diagnosed as Amyotrophic Lateral Sclerosis after Surgery：A Case Report

要旨

　術前から労作時の呼吸困難を訴えていたが，精査には至らず，ロボット支援下膀胱全摘術および回腸導管造設術の術後にCO₂ナルコーシスを契機として呼吸不全が顕在化し，最終的に筋萎縮性側索硬化症（amyotrophic lateral sclerosis：ALS）と診断された症例を報告する。

　A 79-year-old man was scheduled to undergo the transurethral resection of a bladder tumor under general anesthesia. During the preoperative interview, he reported experiencing dyspnea when in the supine position. After the resection surgery, at the end of the period of anesthesia, the patient developed CO₂ retention and postoperative respiratory failure, necessitating reintubation and mechanical ventilation in the operating room. Due to the patient’s persistent respiratory failure, a further evaluation was conducted, and based on the evaluation’s results the patient was diagnosed as having amyotrophic lateral sclerosis on postoperative day 16.