|
文献考察：腹痛を呈した肺塞栓症の文献
１）Eur J Emerg Med. 2003 Jun;10(2):135-8.
A pulmonary embolism case presenting with upper abdominal and flank pain.
Unluer EE, Denizbasi A.
BACKGROUND: The clinical manifestations of pulmonary thromboembolism are non-specific, which makes this condition difficult to diagnose. A case of helical computerized tomography angiographically documented pulmonary thromboembolism, which initially presented as upper abdominal and flank pain, is described. CASE REPORT: A 46-year-old woman was referred to the emergency department for left flank and upper abdominal pain with diaphoresis and nausea. Her history included rheumatoid arthritis 3 years previously. During her examination the only abnormal finding was abdominal tenderness at the right upper quadrant and a positive Murphy sign without other systemic signs. A chest radiograph demonstrated an atelectatic line at the left lung base. The alveolar-arterial gradient was increased, and a ventilation-perfusion scan revealed a mismatch at the left upper and lower lobes, indicative of pulmonary thromboembolism. Helical computerized tomography angiography revealed filling defects on that side. The patient received anticoagulant therapy and gradually improved. CONCLUSION: The pathogenesis of the pain in the flank and upper abdomen is not known in this case. Unexplained upper abdomen and flank pain in a patient with risk factors for pulmonary thromboembolism, such as rheumatoid arthritis, should be investigated to rule out this treatable but potentially fatal condition.PMID: 12789072
２）Respiration. 1996;63(5):318-20.
Pulmonary embolism presenting as acute abdominal pain.
von Pohle WR.
Pulmonary embolism has protean manifestations. This report describes a 20-year-old woman without risk factors with pulmonary embolism presenting as abdominal pain. Previous cases and potential etiologies of pain are reviewed.PMID: 8885008
３）J Emerg Med. 1996 Nov-Dec;14(6):715-7.
Pulmonary embolism presenting as an acute surgical abdomen.
Smith DC.
Pulmonary embolism remains a serious cause of morbidity and mortality. Diagnosis based on clinical manifestations remains difficult. Prior reviews have rarely noted the potential for patients to present with abdominal complaints. Presented here is the case of a 28-yr-old woman who had signs and symptoms of an intra-abdominal catastrophe. The patient underwent laparotomy and at surgery had findings suggesting primary intra-abdominal pathology. Autopsy results indicated that pulmonary embolism was responsible for the patient's presentation and death.PMID: 8969992
|
