| Japanese |
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| Title | 癌性サブイレウスを呈した急性冠症候群の2手術症例 |
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| Subtitle | 症例 |
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| Authors | 岡田修一*, 金子達夫*, 志賀達哉**, 江連雅彦*, 佐藤泰史*, 長谷川豊*, 碓井正**, 小此木修一*, 金本匡史**, 松本直樹**, 滝原瞳* |
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| Authors(kana) | |
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| Organization | *群馬県立心臓血管センター心臓血管外科, **群馬県立心臓血管センター麻酔科 |
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| Journal | 循環制御 |
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| Volume | 31 |
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| Number | 2 |
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| Page | 138-142 |
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| Year/Month | 2010/10 |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「緒言」急性冠症候群(Acute Coronaly Syndrome: 以下ACS)は緊急治療を要する疾患である. 一方, 癌性イレウスも早急に治療を必要とする疾患である. ACSと癌性サブイレウスを呈した症例に対して冠血行再建術を先行後に悪性腫瘍手術を施行した2例を経験した. 「症例」「A. 症例1」72歳の男性. 身長161cm, 体重58kg. 右下腹部痛が出現し前医を受診し造影CTで上行結腸癌を原因とするイレウスと診断された. その際に胸痛が出現し心電図上I, II, aVL, V2〜6でST低下を認めた. 緊急冠動脈造影検査(Emergent CAG)(図1)では左冠動脈主幹部(LMT)90%狭窄, 左冠動脈第一対角枝(D1)は90%狭窄, 左冠動脈回旋枝(LCX)#11は慢性完全閉塞(CTO)(右冠動脈(RCA)から側副血行路あり)で, 左冠動脈前下行枝(LAD)に有意狭窄は認めなかった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | ACS, CABG, Ileus |
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| English |
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| Title | Perioperative Management for Ileus in Patients with Acute Coronary Syndrome |
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| Subtitle | |
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| Authors | Syuichi Okada*, Tatsuo Kaneko*, Tatsuya Shiga**, Masahiko Ezure*, Yasushi Sato*, Yutaka Hasegawa*, Tadashi Usui**, Syuichi Okonogi*, Masafumi Kanemoto**, Naoki Matumoto**, Hitomi Takihara* |
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| Authors(kana) | |
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| Organization | *Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, **Department of Anesthesia, Gunma Prefectural Cardiovascular Center |
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| Journal | Circulation Control |
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| Volume | 31 |
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| Number | 2 |
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| Page | 138-142 |
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| Year/Month | 2010/10 |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control in Medicine |
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| Abstract | We report two cases with severe ischemic coronary disease and ileus because of malignant neoplastic disease. (Case 1) A 72-year-old man who was diagnosed of ascending colonic cancer with ileus complained chest pain. Emergent cardiac catheterization showed left main trunk disease. He received at first off pump coronary artery bypass (OPCAB) and underwent ascending colectomy 15 days after OPCAB. (Case 2) A 79-year-old man with ileus by rectal cancer complained chest pain. Cardiac catheterization showed left main trunk disease. Echocardiogram showed low ejection fraction. He received OPCAB and PCI, and thereafter he underwent low anterior resection for the rectal cancer 26 days after coronary revascularization. Continuous infusions of nicorandil and ladiolol were used during surgeries for maintenance of their hemodynamics. Their postoperative recoveries were smooth and uneventful. |
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| Practice | Basic medicine |
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| Keywords | ACS, CABG, Ileus |
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