Tsuneyoshi H, Minami K, Nakayama S, Sakaguchi G
Department of Cardiovascular Surgery, Osaka Red Cross Hospital, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Aug;46(8):719-23. doi: 10.1007/BF03217808.
A 71-year-old man, who had received coronary angioplasty to right coronary artery 1 year before, was admitted because of unstable angina. An urgent CABG was performed using the left internal thoracic artery and the right gastroepiploic artery. Coronary anastomosis was performed under ventricular fibrillation due to porcelain aorta. Seven days after surgery, abdominal pain was suddenly experienced. A chest X-P showed subphrenic free air. So an emergent laparotomy was performed, and a 2 x 2 cm gastric perforation was found on the anterior wall of the greater gastric curvature. Partial gastrectomy was performed. However, he unfortunately died on the 58th postoperative day for multiple organ failure. Pathological examination of the excised gastric wall revealed ischemic change, not ulcer. This gastric perforation was possibly caused by ischemia after harvesting the right gastroepiploic artery.
一名71岁男性，1年前接受了右冠状动脉冠状动脉成形术，因不稳定型心绞痛入院。使用左胸廓内动脉和右胃网膜动脉进行了紧急冠状动脉旁路移植术（CABG）。由于主动脉呈瓷样改变，在心室颤动下进行了冠状动脉吻合术。术后7天，突然出现腹痛。胸部X线片显示膈下有游离气体。因此进行了急诊剖腹手术，在胃大弯前壁发现一个2×2cm的胃穿孔。进行了部分胃切除术。然而，他不幸在术后第58天因多器官功能衰竭死亡。切除的胃壁病理检查显示为缺血性改变，而非溃疡。这种胃穿孔可能是由于采集右胃网膜动脉后缺血所致。
