Sannomiya Yuta, Miyashita Tomoharu, Kaida Daisuke, Nakamura Naohiko, Miyata Takashi, Fujita Hideto, Ueda Nobuhiko, Takamura Hiroyuki, Yamada Sosuke
Department of Gastrointestinal Surgery, Kanazawa Medical University Hospital.
Department of Pathology, Kanazawa Medical University Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2023;120(4):339-345. doi: 10.11405/nisshoshi.120.339.
A 62-year-old male presented with right intercostal muscle pain. Clinical examination revealed muscular defense in the same area. Abdominal ultrasonography revealed a distended gallbladder and ascites effusion, but no gallstones or polyps were present. Contrast-enhanced computerized tomography was performed, which revealed luminal obstruction due to arterial dissection of the celiac artery and intrinsic hepatic artery. This finding suggested gangrenous cholecystitis; thus, urgent cholecystectomy was performed. Only a few cases of celiac artery dissection and only one case of gangrenous cholecystitis without stones have been reported. We report here an extremely rare case of celiac artery dissection.
一名62岁男性因右侧肋间肌疼痛就诊。临床检查发现同一区域有肌肉防御。腹部超声显示胆囊扩张和腹水渗出,但未发现胆结石或息肉。进行了对比增强计算机断层扫描,结果显示由于腹腔干动脉和肝固有动脉夹层导致管腔阻塞。这一发现提示坏疽性胆囊炎;因此,紧急实施了胆囊切除术。据报道,腹腔干动脉夹层病例仅有少数几例,无结石的坏疽性胆囊炎病例仅有1例。我们在此报告1例极其罕见的腹腔干动脉夹层病例。