縊頸に肺水腫を伴った1例

A Case of Hanging Accompanying Pulmonary Edema

要旨　35歳男性が縊頸を行い，心停止となった．救急救命士が気管挿管と1mgのエピネフリンを投与を用いた心肺蘇生術を施行した．搬送中，胸骨圧迫とともに気管挿管チューブから淡血性泡沫状の液体流出を認めた．病院到着後も蘇生術を継続したが，心拍再開しなかった．胸部X線写真では，著明な肺水腫を合併していた．病理解剖は家族が望まなかった．

　縊頸に伴う肺水腫は非常に稀である．その機序に関してOswaltらの仮説を紹介した．

　A thirty-five-year-old male collapsed due to attempted suicide by hanging himself. An emergency life-saving technician performed cardiopulmonary resuscitation(CPR) for him with tracheal intubation and infusion of 1 mg of epinephrine at the scene of the hanging. During transportation, bloody foamy fluid caused by chest compression was observed through the intubation tube. The CPR was successful, but, after arriving at the hospital, recovery of spontaneous circulation could not be obtained. A chest roentgen demonstrated severe bilateral lung edema. An autopsy was not permitted by his family.

　Pulmonary edema complicating hanging is extremely rare. For this reason, we introduced the previous Oswalt's hypothesises concerning this mechanism.