血管内手術で救命しえた気管支動脈瘤破裂

Endovascular Treatment of a Ruptured Mediastinal Bronchial Artery Aneurysm

気管支動脈瘤破裂は初期診断を間違えると死亡にいたることもあるまれな疾患である．われわれは，急性大動脈症候群（それぞれ急性大動脈解離破裂・感染性胸部大動脈瘤破裂）の診断で紹介され，CTで気管支動脈瘤破裂と診断し救命しえた2例を経験したので，若干の文献的考察を加えて報告する．

Case 1：A 73-year-old man was transported to our hospital for evaluation of sudden onset of chest pain, back pain, and dyspnea. We initially misdiagnosed him with advanced esophageal cancer accompanied by mediastinal metastasis；however, subsequent multi-detector row computed tomography （MDR-CT） confirmed the diagnosis. We performed coil embolization of a bronchial artery aneurysm and thoracic endovascular aortic repair （TEVAR） to seal the root of the bronchial artery.

Case 2：An 81-year-old woman with a one-week history of fever and cervical pain was diagnosed with a ruptured infected thoracic aneurysm. She underwent the same treatment as described in Case 1.

Physicians should consider it as a differential diagnosis of mediastinal hematoma.