仲原 正明¹, 藤田 修弘¹, 中尾 量保¹, 荻野 信夫¹, 西田 俊朗¹, 宮崎 知¹, 中村 順一¹, 脇 英彦²

Masaaki NAKAHARA¹, Nobuhiro FUJITA¹, Kazuyasu NAKAO¹, Nobuo OGINO¹, Toshirou NISHIDA¹, Satoru MIYAZAKI¹, Jun-ichi NAKAMURA¹, Hidehiko WAKI²

¹大阪警察病院救急外科,外科,, ²大阪警察病院研究検査科

¹Department of Emergency and Clitical Care Medicine, Surgery Osaka Police Hospital, ²US Laboratory Osaka Police Hospital

キーワード : Superior Mesenteric Arterial Occulsion, Ultrasonography, Doppler Flowmetry, Cardiac Output, Portal Flow

A case of superior mesenteric artery (SMA) occlusion diagnosed by Doppler Ultrasonography was reported. A 75-year-old woman suffering abdominal pain was admitted to our emergency medicine. Physical examination revealed a little tenderness on lower abdomen, and serum level of CPK increased to 140 U/l. Ultrasonographic examination showed high echoic lesion in the origin of SMA. The flow volume of portal vein and SMA, measured by Doppler ultrasonography, showed a considerable decrease to 0.12 and 0.05 l/min, respectively. The ratio of portal flow to cardiac output was 0.034. These data strongly suggested occulsion of SMA. A subsequent superior mesenteric arteriography comfirmed complete obstruction at 3.7 cm from its origin. Embolectomy with a Fogarty catheter and partial resection of ileum were performed in an emergency operation within 3 hours after the ultrasonographic examination. Thus Doppler ultrasonography is useful in an early and non-invasive diagnosis of SMA occulusion.