Norita H, Ohteki H, Yoshitake K, Hisanou R, Todaka K, Yamada M, Yonemura T, Furukawa T, Ijima H
Department of Cardiovascular Surgery, Saga Prefectural Hospital Kohseikan, Saga, Japan.
Kyobu Geka. 1993 Jul;46(8 Suppl):727-30.
We present a case who received the simultaneous surgical corrections of unstable angina, acute gastric ulcer, and cholelithiasis. A 72-year-old man was admitted to our hospital due to unstable angina. An emergency coronary angiography was performed and we found severe 2 vessels disease (RCA ostium and proximal LAD lesions). After the admission, the angina was poorly controlled and the surgical treatment had been considered. The patient developed sudden hematemesis due to the uncontrolled bleeding from gastric ulcer. Then the emergency operation was performed. Partial gastrectomy with preservation of RGEA and cholecystectomy were done followed by CABG to RCA with RGEA and to LAD with autologous saphenous vein. The postoperative course was uneventful and the patient is in good condition to date.
我们报告一例同时接受不稳定型心绞痛、急性胃溃疡和胆结石手术矫正的病例。一名72岁男性因不稳定型心绞痛入住我院。进行了急诊冠状动脉造影，我们发现严重的双支血管病变（右冠状动脉开口和左前降支近端病变）。入院后，心绞痛控制不佳，已考虑进行手术治疗。患者因胃溃疡出血无法控制而突然呕血。随后进行了急诊手术。行保留右胃网膜动脉的胃部分切除术和胆囊切除术，然后用右胃网膜动脉对右冠状动脉进行冠状动脉旁路移植术，并用自体大隐静脉对左前降支进行冠状动脉旁路移植术。术后过程顺利，患者至今状况良好。
