透析カテーテル留置による腸骨静脈穿孔:症例報告
1Department of Vascular Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
JPMA. The Journal of the Pakistan Medical Association
|February 25, 2026
まとめ
右総腸骨静脈穿孔という血液透析カテーテル留置のまれな合併症が、大規模な後腹膜血腫と出血性ショックにつながりました。この症例は、末期腎不全患者における中心静脈カテーテル留置中の重度の血管損傷の可能性を強調しています。
科学分野:
- 腎臓病学
- 血管外科
- インターベンショナルラジオロジー
背景:
- 中心静脈カテーテル留置は、末期腎不全の血液透析に不可欠です。
- 血管破裂や出血などの合併症が発生する可能性があり、重大なリスクをもたらします。
- 腸骨静脈穿孔は、血液透析カテーテル留置の未記載の合併症です。
研究 の 目的:
- 血液透析カテーテル留置中の右総腸骨静脈穿孔のユニークな症例を報告すること。
- 結果として生じる大規模な後腹膜血腫および出血性ショックを記述すること。
- 重度の血管損傷の可能性と管理の課題を強調すること。
主な方法:
- 症例報告の提示。
- 臨床症状、診断画像、および管理のレビュー。
- 病因と潜在的な予防戦略の議論。
主要な成果:
- 患者は血液透析カテーテルによる右総腸骨静脈穿孔を経験しました。
- これにより、腸腰筋にまで及ぶ大規模な後腹膜血腫が生じました。
- 患者は生命を脅かす出血性ショックを呈しました。
結論:
- 腸骨静脈穿孔は、血液透析カテーテル留置のまれではあるが重大な合併症です。
- 患者の生存のためには、迅速な認識と管理が不可欠です。
- この症例は、中心静脈アクセス手順中の細心の技術と注意の重要性を強調しています。
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