アブストラクト(52巻1/2号:神奈川歯学)

神奈川歯学

Japanese

Title : 術前動注化学療法中, 上腸間膜動脈症候群による悪心症状に苦慮した上顎歯肉癌の1例
Subtitle : 症例
Authors : 大澤孝行, 小泉文, 鈴木健司*, 岩渕博史*
Authors(kana) :
Organization : 横浜市立市民病院歯科口腔外科 (主任:大澤孝行部長), *神奈川歯科大学大学院歯学研究科顎顔面病態診断治療学講座顎顔面外科学分野 (主任:小林優教授)
Journal : 神奈川歯学
Volume : 52
Number : 1/2
Page : 40-44
Year/Month : 2017 / 12
Article : 報告
Publisher : 神奈川歯科大学学会
Abstract : 「緒言」 口腔癌に対する化学療法の有害事象として, 悪心嘔吐は高頻度に認められる. これらの症状の発現は化学療法の遂行に支障をきたし, またQOLを著しく低下させることよりその予防と治療が非常に重要である. 上腸間膜動脈(以下SMA)症候群は, 十二指腸が上腸管膜動脈と腹部大動脈との間で圧迫され通過障害をきたす病態であり悪心嘔吐などの消化管症状を認め, 時には神経症的な食欲不振を呈する. 今回我々は, 上顎歯肉癌に対する浅側頭動脈からの術前動脈内投与による化学療法中の遷延する悪心症状がSMA症候群に起因すると示唆された1例を経験したので報告する. 「症例」 患者: 78歳, 男性. 主訴: 右側上顎歯肉部の疼痛. 既往歴: 胃潰瘍, 慢性胃炎. 家族歴: 特記事項なし. 現病歴: 初診1週間ほど前より右側上顎歯肉部の疼痛を自覚し, かかりつけ内科より横浜市立市民病院歯科口腔外科を紹介され受診した.
Practice : 歯科学
Keywords : SMA症候群, 化学療法, 上顎歯肉癌, 有害事象

English

Title : A case of upper gingival carcinoma complicated with retching symptom associated with superior mesenteric artery (SMA) syndrome during intra-arterial induction chemotherapy
Subtitle :
Authors : Takayuki OHSAWA, Aya KOIZUMI, Kenji SUZUKI*, Hiroshi IWABUCHI*
Authors(kana) :
Organization : Department of Detistry and Oral & Maxillofacial surgery, Yokohama municipal citizen's hospital (Chief: Takayuki OHSAWA), *Division of Oral and Maxillofacial Surgery, Department of Dentomaxillofacial Diagnosis and treatment, Graduate School of Dentistry, Kanagawa Dental University (Chief: Masaru KOBAYASHI)
Journal : Kanagawa Shigaku
Volume : 52
Number : 1/2
Page : 40-44
Year/Month : 2017 / 12
Article : Report
Publisher : Kanagawa Odontological Society
Abstract : [Abstract] Frequent nausea and vomiting are adverse effects of chemotherapy for oral cancer. Their prevention is very important because these digestive symptoms impair chemotherapeutic efficacy and deteriorate the patient's quality of life (QOL). We report the case of a patient with prolonged retching symptoms associated with superior mesenteric artery (SMA) syndrome who underwent chemotherapy for upper gingival cancer. SMA syndrome is an unusual cause of proximal intestinal obstruction. The syndrome is characterized by compression of the duodenum due to narrowing of the space between the SMA and the aorta and is primarily attributed to loss of the intervening mesenteric fat pad. A 78-year-old man with upper gingival cancer underwent induction chemotherapy using intra-arterial injections. On day 6, he had inappetence, nausea, and cold sweat. Thereafter, various adverse events started occuring. On day 16, drug hepatopathy was noted. For close inspection computed tomography was performed and SMA syndrome was confirmed. A major component of therapy is nutritional support. We planned reversal of weight loss by using intravenous hyperalimentation. About 4 weeks weight loss was corrected and the retching disappeared. Thus, the possibility of SMA syndrome should be considered when prolonged retching and inappetence are found in patients undergoing chemotherapy.
Practice : Dentistry
Keywords :