非外傷性腹直筋血腫の1例 - mlib.kitasato-u.ac.jp

1 133 2013; 43: 133-136 Received 28 August 2013, accepted 15 October 2013 : ( ) 252-0374 1-15-1E-mail: 1 1,3 2,3 3 3 31 2 3 38 7 CT Key words: 1 1 : 38.

2 1 2007 8 158 cm 53 kg 115/75 mmHg C (Bouchacourt ) (Fothergill ) : 11,500/ l CRP mg/dl CPK 336 U/l : CT 8 cm (Figure 1A) CT (Figure 1B) 2 MRI (T1 ) (Figure 2 )

3 3 5 134 Figure 1 7 3 5 cm 7 CT (Figure 3) 2-5 6,7 8,9 A. Computed tomography demonstrates asymmetryof rectus sheath with rectus sheath hematoma at Day 1(arrowhead).B. Enhanced abdominal computed tomographyshowed a mass of the abdominal wall leading toenlargement of the right rectus abdominis muscle fromhematoma with signs of bleeding at Day 1 (arrow).

4 A. Coronal section (arrow)B. Axial section (arrow)Figure2. Magnetic resonance image (T1WI) shows hematoma in rectus abdominis muscle at Day 3. Follow-up computed tomography at 7 weeks,hematomas had resolved or decreased in 1 10,11 12 Kapsinow 11 142 49.

5 93 6 10 7 3 11,13,14 C 2,15,16 2,17 CRP CPK 7 CPK 18 14 MRI 9 30 mm 90 mm 2 MRI 19

6 MRI 8,11,14 5 9,15 5 CT Interventional radiology( IVR) 20 IVR 1 1.

7 1 . 1998; 59: 3158-62. 2.. 3 . 2005; 32: 191-6. 3.. 1 . 2005; 60: 400-1. 4.. 2 . 2003; 92: 994-7. 5.. 1 . 2003; 58: 1121-3. 6.. 1 142 . 2005; 29: 622-5. 7.. 1 . 2003; 65: 337-9. 8.. 2005; 25: 747-51. 9.. 1 . 2001; 37: . 2 . 2002;99: Kapsinow R. Rupture of the deep epigastric artery.

8 New OrleansMed Soc J 1946; 98: A case of nontraumatic rectus sheath hematomaChihiro Saito,1,3 Rieko Kitamura,2,3 Takayuki Sugimoto,3 Akira Takeda,3 Eiju Uchinuma31 Plastic and Aesthetic Surgery, Yokohama Minami Kyosai Hospital2 Plastic Surgery, Yokosuka Kyosai Hospital3 Department of Plastic and Aesthetic Surgery, Kitasato University School of MedicineA 38-year-old woman presented with a nontraumatic rectus sheath hematoma associated with cough. Sherecovered after 1 week admission without surgical treatment.

9 Nontraumatic rectus sheath hematoma is acomparatively rare disease caused by bleeding into the rectus sheath, usually after the rupture of the superiorand inferior epigastric vessels combined with a primary tear of the rectus muscle fibers. Physicians should beaware of the possibility of this disease when diagnosing abdominal words:nontraumatic rectus sheath hematoma, abdominal mass, abdominal pain12.. 1 . 1992; 53: . 2 . 1998; 59: . 1.

10 1980; 41: . CT 1 . 1991; 41: GM, Spitz HB. Ultrasound in the diagnosis of rectus sheathhematoma. JAMA 1994; 241: . Multidetector-row CT(MDCT) . 2009; 101: Oni OO, Fenton A, Iqbal SJ, et al. Prognostic indicators in tibialshaft fractures: serum creatinine kinase activity. J Orthop Trauma1989; 3: JD, Garcia-Medina V, Guirao J, et al. Rectus sheathhematoma: diagnotic classification by CT. Abdom Imaging 1996;21: J, Perendreu J, Falco J, et al.