Yamamoto Satoshi, Yokomizo Yuriko, Akai Takafumi, Chiyoda Takehiro, Goto Hiroshi, Masaki Yukiyoshi
Department of Surgery, Ome Municipal General Hospital, 4-16-5, Higashi Ome, Ome-shi, Tokyo, 198-0042, Japan.
Surg Case Rep. 2016 Dec;2(1):121. doi: 10.1186/s40792-016-0251-5. Epub 2016 Nov 2.
Patients with spinal cord injury experience changes in the cardiovascular system and a high morbidity associated with peripheral artery disease. We report a case of acute aortic occlusion in a patient with chronic paralysis due to spinal cord injury. A 65-year-old man with chronic paralysis due to spinal cord injury developed mottling of the right extremity. Because of the complete tetraplegia, the patient had no subjective symptoms. Computed tomography revealed occlusion of the infrarenal abdominal aorta. An emergency thromboembolectomy established adequate blood flow, and the postoperative course was uneventful. The loss of muscle mass might be an advantage in avoiding ischemia reperfusion syndrome. Early detection of acute aortic occlusion and immediate reperfusion are primarily important, but patients with chronic paralysis present a risk of delay in detection, diagnosis, and treatment of acute aortic occlusion because of motor or sensory deficits. Although rare, it is necessary to consider acute aortic occlusion in the case of acute limb ischemia in patients with chronic paralysis due to spinal cord injury.
脊髓损伤患者会出现心血管系统变化以及与外周动脉疾病相关的高发病率。我们报告一例因脊髓损伤导致慢性瘫痪的患者发生急性主动脉闭塞的病例。一名65岁因脊髓损伤导致慢性瘫痪的男性出现右下肢斑纹。由于完全性四肢瘫，患者无主观症状。计算机断层扫描显示肾下腹主动脉闭塞。急诊血栓切除术建立了充足的血流，术后病程平稳。肌肉量的减少可能是避免缺血再灌注综合征的一个优势。急性主动脉闭塞的早期检测和立即再灌注至关重要，但由于运动或感觉缺陷，慢性瘫痪患者存在急性主动脉闭塞检测、诊断和治疗延迟的风险。虽然罕见，但对于因脊髓损伤导致慢性瘫痪的患者出现急性肢体缺血的情况，有必要考虑急性主动脉闭塞。
