腹部血管造影異常のみられた虚血性大腸炎の1例

Ischemic Colitis with the Abnormal Findings in Abdominal Angiograms

　患　者：渡○水○，65歳，男．

　主　訴：左下腹部痛．

　現病歴：1978年4月22日夕，急に心窩部不快感があり食物残さを嘔吐す．微熱・左下腹部痛を伴うようになり近医にて投薬受けるも症状軽快せず．4月24日より下痢（軟便・黄色で3行）も出現し，徐々に左下腹部痛増強す．4月25日朝より目まいあり近医にて血圧60mmHgとショック状態となり当院に緊急入院となる．

　A 65 year-old man experienced a sudden onset of vomiting and abdominal pain, followed by hypovolemic shock. Abdominal angiograms were performed as the first diagnostic procedure, which revealed the stenotic changes of the inferior mesenteric artery and no arterial filling of the vessels supplying the descending colon. A diagnosis of ischemic colitis was considered by barium meal study of the colon. The subtotal colectomy was done and the necrotic change with penetration was seen in the descending colon.