Katayama Hideyuki, Shimamoto Takeshi, Sakaguchi Genichi, Ijuin Shinichi, Komiya Tatsuhiko
Department of Cardiovascular Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
Gen Thorac Cardiovasc Surg. 2014 Jun;62(6):383-5. doi: 10.1007/s11748-013-0259-8. Epub 2013 May 1.
An 84-year-old male on oral steroids, coumadin and multiple antiplatelets for stented superficial femoral artery presented to our hospital with chest oppression. His CT scan showed cardiac tamponade with periaortic hematoma. At first, sealed rupture of aortic dissection with thrombosed false lumen was suspected. However, delayed enhancement view revealed extravasation of contrast agent, which appeared to drain into the pericardium or pericardial space. Emergency thoracotomy revealed normal aorta with several small spurting vessels of pulmonary side of the pericardium. To the best of our knowledge, this is the first reported case in the literature of a parietal pleural hematoma without known cause such as malignancy or hematologic disorders.
一名84岁男性，因股浅动脉支架置入术服用口服类固醇、华法林和多种抗血小板药物，因胸部压迫感入住我院。他的CT扫描显示心脏压塞伴主动脉周围血肿。起初，怀疑是主动脉夹层破裂伴血栓形成的假腔封闭。然而，延迟增强视图显示造影剂外渗，似乎流入心包或心包腔。急诊开胸手术显示主动脉正常，心包肺侧有几条小喷血血管。据我们所知，这是文献中首次报道的无恶性肿瘤或血液系统疾病等已知病因的壁层胸膜血肿病例。
