ステントグラフト内挿術により嚥下障害・嗄声・喘息様症状が改善した胸部大動脈瘤の1例
症例は69歳，女性．嚥下障害，嗄声，咳嗽・喘鳴などの喘息様症状を主訴に近医を受診した．吸入ステロイド薬・長時間作用型β2 刺激薬投与で改善が得られなかった．上部消化管内視鏡検査で食道内壁の外部からの圧排像があり，CT像で胸部下行大動脈瘤がみられたため，当院に紹介となった．胸部大動脈瘤の食道・左気管支への圧排による嚥下障害・呼吸器症状と診断し，早期に胸部大動脈ステントグラフト内挿術を行った．術後経過は良好で，手術後1カ月の時点で嗄声と喘息様発作の著明な改善が得られた．ステントグラフト内挿術により，食道および気管支狭窄症状の両方の改善が得られた症例は本邦ではいまだなく，稀と考えられたので報告する．...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 46; no. 1; pp. 49 - 53 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本心臓血管外科学会
2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.46.49 |
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| Abstract | 症例は69歳，女性．嚥下障害，嗄声，咳嗽・喘鳴などの喘息様症状を主訴に近医を受診した．吸入ステロイド薬・長時間作用型β2 刺激薬投与で改善が得られなかった．上部消化管内視鏡検査で食道内壁の外部からの圧排像があり，CT像で胸部下行大動脈瘤がみられたため，当院に紹介となった．胸部大動脈瘤の食道・左気管支への圧排による嚥下障害・呼吸器症状と診断し，早期に胸部大動脈ステントグラフト内挿術を行った．術後経過は良好で，手術後1カ月の時点で嗄声と喘息様発作の著明な改善が得られた．ステントグラフト内挿術により，食道および気管支狭窄症状の両方の改善が得られた症例は本邦ではいまだなく，稀と考えられたので報告する． |
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| AbstractList | 症例は69歳，女性．嚥下障害，嗄声，咳嗽・喘鳴などの喘息様症状を主訴に近医を受診した．吸入ステロイド薬・長時間作用型β2 刺激薬投与で改善が得られなかった．上部消化管内視鏡検査で食道内壁の外部からの圧排像があり，CT像で胸部下行大動脈瘤がみられたため，当院に紹介となった．胸部大動脈瘤の食道・左気管支への圧排による嚥下障害・呼吸器症状と診断し，早期に胸部大動脈ステントグラフト内挿術を行った．術後経過は良好で，手術後1カ月の時点で嗄声と喘息様発作の著明な改善が得られた．ステントグラフト内挿術により，食道および気管支狭窄症状の両方の改善が得られた症例は本邦ではいまだなく，稀と考えられたので報告する． |
| Author | 六角, 丘 大島, 哲 松永, 裕樹 石川, 進 三島, 秀樹 |
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| References | 7) Kikuchi, S., Itoh, T., Eduoka, M. et al. : Replacement of the aortic valve and ascending aorta for annuloaortic ectasia with severe tracheobronchial compression in an elderly patient. Kyobu Geka 44 : 500-502, 1991. 16) Aoki, Y., Kato, O., Nakanishi, Y. et al. : A case of tracheopathia osteochondroplastica accompanied with an aneurysm of the thoracic aorta. J. Jpn. Soc. Bronchol. 11 : 604-607, 1989. 9) Yusa, H., Nishiya, Y., Murata, A. et al. : Severe tracheal compression resulting from atherosclerotic aortic arch aneurysm ; report of a case. Kyobu Geka 58 : 1077-1080, 2005. 12) Takeuchi, E., Tanaka, M., Yasuura, K. et al. : LMT, LAD byouhenn niyoru kyousinsyou, syokudou appaku niyoru enge konnan wo gappei sita kyouhukubu daidoumyakuryuu syuzyutu. Jpn. J. Cardiovasc. Surg. 19 : 1166-1668, 1990. 5) Sakai, O., Murayama, Y., Numata, S. et al. : A case of esophageal stenosis with descending aortic elongation (dysphagia aortica). Jpn. J. Cardiovasc. Surg. 34 : 134-136, 2005. 17) Siddiqui, J. and Hughes, F. : Dysphagia due to thoracic aortic aneurysm, relieved by thoracic endovascular aneurysm repair : a case report and review of the literature. BMJ Case Rep., 2011. doi : 10.1136/bcr.09.2011.4793 11) Ando, Y., Sakamoto, M., Yokozuka, M. et al. : Anesthetic management of thoracic aortic aneurysm with severe tracheal stenosis. Cardiovasc. Anesth. 17 : 139-144, 2007. 13) Harada, H., Ichimiya, Y. and Ueda, M. : Surgical treatment of the thoracoabdominal aortic aneurysm with dysphagia. J. Jpn. Pract. Surg. Soc. 52 : 2627-2631, 1991. 10) Taguchi, S., Ko, Y. and Horikoshi, S. : A case of saccular aortic arch aneurysm dilating between trachea and esophagus. Tokyo Jikeikai Med. J. 122 : 137-141, 2007. 2) Sekimura, K. and Yamauti, K. : Manseigaisou no genin tosite kyoubudaidoumyakuryuu no kannyogasisasareta ichirei. Int. Rev. Asthma. COPD 15 : 29-31, 2013. 3) Tsubaki, K., Ishii, K., Adachi, H. et al. : Examination of thoracic aortic aneurysm-related laryngeal paralysis. Practica Otologica 97 : 803-806, 2004. 4) Kim, J.H., Jang, S.W., Kim, D.B. et al. : A patient with dysphagia due to an aortic aneurysm. Korean Circ. J. 39 : 258-260, 2009. 14) Furukawa, H., Tsuchiya, K. and Osawa, H. : Saccular descending thoracic aortic aneurysm with dysphagia. Jpn. J. Thorac. Cardiovasc. Surg. 47 : 277-280, 1999. 8) Onoguchi, K., Hachiya, T., Sasaki, T. et al. : Jaundice after surgery for an aortic arch aneurysm. Jpn. J. Thorac. Cardiovasc. Surg. 49 : 388-390, 2001. 1) Elefteriades, J.A. and Farkas, E.A. : Thoracic aortic aneurysm clinically pertinent controversies and uncertainties. J. Am. Coll. Cardiol. 55 : 841-857, 2010. 15) Hori, D., Yuri, K., Nomura, Y. et al. : Case report : successful endovascular treatment of saccular thoracic aneurysm with “shaggy aorta”. Ann. Thorac. Cardiovasc. Surg. 18 : 536-539, 2012. 6) Oda, K., Tanemoto, K., Ishine, N. et al. : A case of chronic traumatic aneurysm with compression of left main bronchus at the ithmus. Nihon Kyobu Geka Gakkai Zasshi 38 : 2436-2439, 1990. |
| References_xml | – reference: 2) Sekimura, K. and Yamauti, K. : Manseigaisou no genin tosite kyoubudaidoumyakuryuu no kannyogasisasareta ichirei. Int. Rev. Asthma. COPD 15 : 29-31, 2013. – reference: 15) Hori, D., Yuri, K., Nomura, Y. et al. : Case report : successful endovascular treatment of saccular thoracic aneurysm with “shaggy aorta”. Ann. Thorac. Cardiovasc. Surg. 18 : 536-539, 2012. – reference: 13) Harada, H., Ichimiya, Y. and Ueda, M. : Surgical treatment of the thoracoabdominal aortic aneurysm with dysphagia. J. Jpn. Pract. Surg. Soc. 52 : 2627-2631, 1991. – reference: 12) Takeuchi, E., Tanaka, M., Yasuura, K. et al. : LMT, LAD byouhenn niyoru kyousinsyou, syokudou appaku niyoru enge konnan wo gappei sita kyouhukubu daidoumyakuryuu syuzyutu. Jpn. J. Cardiovasc. Surg. 19 : 1166-1668, 1990. – reference: 14) Furukawa, H., Tsuchiya, K. and Osawa, H. : Saccular descending thoracic aortic aneurysm with dysphagia. Jpn. J. Thorac. Cardiovasc. Surg. 47 : 277-280, 1999. – reference: 17) Siddiqui, J. and Hughes, F. : Dysphagia due to thoracic aortic aneurysm, relieved by thoracic endovascular aneurysm repair : a case report and review of the literature. BMJ Case Rep., 2011. doi : 10.1136/bcr.09.2011.4793 – reference: 1) Elefteriades, J.A. and Farkas, E.A. : Thoracic aortic aneurysm clinically pertinent controversies and uncertainties. J. Am. Coll. Cardiol. 55 : 841-857, 2010. – reference: 3) Tsubaki, K., Ishii, K., Adachi, H. et al. : Examination of thoracic aortic aneurysm-related laryngeal paralysis. Practica Otologica 97 : 803-806, 2004. – reference: 5) Sakai, O., Murayama, Y., Numata, S. et al. : A case of esophageal stenosis with descending aortic elongation (dysphagia aortica). Jpn. J. Cardiovasc. Surg. 34 : 134-136, 2005. – reference: 9) Yusa, H., Nishiya, Y., Murata, A. et al. : Severe tracheal compression resulting from atherosclerotic aortic arch aneurysm ; report of a case. Kyobu Geka 58 : 1077-1080, 2005. – reference: 4) Kim, J.H., Jang, S.W., Kim, D.B. et al. : A patient with dysphagia due to an aortic aneurysm. Korean Circ. J. 39 : 258-260, 2009. – reference: 11) Ando, Y., Sakamoto, M., Yokozuka, M. et al. : Anesthetic management of thoracic aortic aneurysm with severe tracheal stenosis. Cardiovasc. Anesth. 17 : 139-144, 2007. – reference: 16) Aoki, Y., Kato, O., Nakanishi, Y. et al. : A case of tracheopathia osteochondroplastica accompanied with an aneurysm of the thoracic aorta. J. Jpn. Soc. Bronchol. 11 : 604-607, 1989. – reference: 6) Oda, K., Tanemoto, K., Ishine, N. et al. : A case of chronic traumatic aneurysm with compression of left main bronchus at the ithmus. Nihon Kyobu Geka Gakkai Zasshi 38 : 2436-2439, 1990. – reference: 10) Taguchi, S., Ko, Y. and Horikoshi, S. : A case of saccular aortic arch aneurysm dilating between trachea and esophagus. Tokyo Jikeikai Med. J. 122 : 137-141, 2007. – reference: 7) Kikuchi, S., Itoh, T., Eduoka, M. et al. : Replacement of the aortic valve and ascending aorta for annuloaortic ectasia with severe tracheobronchial compression in an elderly patient. Kyobu Geka 44 : 500-502, 1991. – reference: 8) Onoguchi, K., Hachiya, T., Sasaki, T. et al. : Jaundice after surgery for an aortic arch aneurysm. Jpn. J. Thorac. Cardiovasc. Surg. 49 : 388-390, 2001. |
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| Snippet | 症例は69歳，女性．嚥下障害，嗄声，咳嗽・喘鳴などの喘息様症状を主訴に近医を受診した．吸入ステロイド薬・長時間作用型β2... |
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| SubjectTerms | TEVAR 喘息様発作 嚥下障害 胸部大動脈瘤 |
| Title | ステントグラフト内挿術により嚥下障害・嗄声・喘息様症状が改善した胸部大動脈瘤の1例 |
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