臨床整形外科47巻2号

2012年02月発行

症例報告

腹痛を主訴とした胸椎椎間板ヘルニアの1例

著者： 藤原啓恭¹ 海渡貴司¹ 牧野孝洋¹ 米延策雄¹

所属機関： ¹独立行政法人国立病院機構大阪南医療センター整形外科

ページ範囲：P.167 - P.171

　比較的稀な腹痛を主訴とした胸椎椎間板ヘルニアの症例を経験した．症例は45歳の男性で，急性発症の腹痛を主訴に消化器内科を受診するが異常は指摘されず，下肢運動麻痺の合併のため整形外科を紹介され受診し，胸椎椎間板ヘルニアの診断に至った．手術治療により腹痛の消失および脊髄症状の改善を得た．胸椎椎間板ヘルニアは，胸壁や胸神経根のデルマトームに一致した神経根症状や下肢麻痺などの脊髄症状に加え，非典型的な胸痛・腹痛などの消化器疾患，循環器疾患を疑う多彩な症状を呈するものがある．診断の遅延・誤診を回避するため，これら症状の合併を念頭に置き，重篤な脊髄症状に移行するまでに神経学的所見と画像所見から早期診断に至ることが重要である．

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