吉牟田 剛¹, 岡島 年也², 柳生 剛³, 久保田 義則⁴, 山岸 正和¹

Tsuyoshi YOSHIMUTA¹, Toshiya OKAJIMA², Takeshi YAGYU³, Yoshinori KUBOTA⁴, Masakazu YAMAGISHI¹

¹金沢大学循環器病態内科学・保健管理センター, ²こだま病院循環器内科, ³国立循環器病研究センター心臓血管内科部門・血管科, ⁴北播磨総合医療センター中央検査室

¹Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, ²Division of Cardiology, Kodama Hospital, ³Department of Cardiology, National Cerebral and Cardiovascular Center, ⁴Department of Clinical Laboratory, Kita-Harima Medical Center

キーワード : corkscrew sign, Buerger’s disease, ultrasound

バージャー病は，四肢の中，小血管に好発し，非特異的な原因不明の慢性血管炎により，狭窄，閉塞を来す疾患である．本疾患は50歳未満の喫煙者において発症し，虚血症状に伴う冷感，知覚異常，間歇性跛行，安静時疼痛，潰瘍等の症状を呈する．診断は，血管造影検査による動脈の形態学的所見が重要で，末梢動脈の閉塞と側副血管路の所見からなされる．特にコルク栓抜き状の側副血行路の所見はcorkscrew signと称され，本疾患の特徴的な所見である．本稿では，corkscrew signについて言及する．

Thromboangitis obliterans (Buerger’s disease) is a non-atherosclerotic, segmental inflammatory disease that commonly affects small and medium-sized distal arteries, veins, and nerves of the upper and lower extremities in heavy tobacco smokers before the age of 50 years. As with atherosclerotic obliterans, manifestations of Buerger’s disease are intermittent claudication, leg pain at rest, and ulceration of extremities. Therefore, accurate diagnosis of Buerger’s disease is important to provide appropriate therapy to the patient. The presence of the corkscrew sign, collateralization around areas of occlusion, is a characteristic finding of Buerger’s disease. This paper presents the corkscrew sign involving both the upper and lower limbs.