A surgically treated case of marked hypoxemia caused by pulmonary arterio-venous fistula
| Jazyk: | japonština |
|---|---|
| Rok vydání: | 2008 |
| Předmět: | |
| Zdroj: | 日本呼吸器外科学会 = The Japanese Association for Chest Surgery. 22(6):953-956 |
| ISSN: | 0919-0945 |
| Popis: | 金沢大学医薬保健研究域医学系 症例は66歳,女性.主訴はチアノーゼ.他疾患治療中にチアノーゼを指摘され当院紹介となった.胸部造影CT検査では右下肺静脈へ直接流入する右A^8に加え右S^6胸膜直下に拡張した動静脈を認めた.肺動脈造影検査では右A^8から左房へのシャント血流を認めた.肺血流シンチでは肺外臓器への核種分布が確認され,右左シャントの存在は明らかでありシャント率は42%と計算された.以上より多発肺動静脈瘻と診断し右下葉切除術を行った.術前に45.0mmHgであった動脈血酸素分圧が術後には90.6mmHgと著明なる改善を認めるなど術後経過は良好であり,19病日に退院した. The patient was a 66-year-old female. In the course of therapy for compression fracture, cyanosis was pointed out. Chest CT scan revealed abnormal vessels in the right S^6 sub-pleura and the direct connection between the right A^8 and right inferior pulmonary vein. Pulmonary angiography showed shunt flow into the atrium. Perfusion scintigraphy revealed extrapulmonary activity due to the right-to-left shunt and a high-level shunt ratio. The diagnosis of pulmonary arterio-venous fistula was made on the basis of these findings. A right lower lobectomy was performed via video-assisted thoracic surgery. Severe hypoxemia was improved after surgery. The postoperative course was uneventful, and the patient was discharged on the 19^ POD. |
| Databáze: | OpenAIRE |
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