Gen Shiko, Usui Ryuichi, Sasaki Takaya, Nobe Kanako, Takahashi Aya, Okudaira Keisuke, Ikeda Naofumi
Department of Nephrology, Saitama Sekishinkai Hospital, Japan.
Intern Med. 2016;55(10):1327-9. doi: 10.2169/internalmedicine.55.5631. Epub 2016 May 15.
A 79-year-old man on hemodialysis was hospitalized for further investigation. Early gastric cancer was diagnosed by gastrointestinal endoscopy and endoscopic submucosal dissection (ESD) was performed. Fever and abdominal pain thereafter developed, and a severe inflammatory response was observed on a blood test. Contrast computed tomography (CT) showed ulcer-like projections and soft tissue surrounding the aorta, from the celiac to left renal artery. An infected aneurysm was diagnosed. Although infected aneurysms developing after laparoscopic cholecystectomy or biopsy of contiguous esophageal duplication cyst have been reported, those developing after ESD have not. When fever and abdominal pain develop after ESD, an infected aneurysm should be considered and contrast CT performed.
一名接受血液透析的79岁男性因进一步检查而住院。通过胃肠内镜检查诊断为早期胃癌,并进行了内镜黏膜下剥离术(ESD)。此后出现发热和腹痛,血液检查显示有严重的炎症反应。增强计算机断层扫描(CT)显示从腹腔干至左肾动脉水平的主动脉周围有溃疡样突起和软组织。诊断为感染性动脉瘤。虽然已有腹腔镜胆囊切除术后或邻近食管重复囊肿活检后发生感染性动脉瘤的报道,但ESD后发生的尚未见报道。ESD后出现发热和腹痛时,应考虑感染性动脉瘤并进行增强CT检查。