{"created":"2023-06-19T10:43:02.177033+00:00","id":3144,"links":{},"metadata":{"_buckets":{"deposit":"d18b6420-b4dc-4d1e-9927-ca777ff5bca9"},"_deposit":{"created_by":11,"id":"3144","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"3144"},"status":"published"},"_oai":{"id":"oai:shiga-med.repo.nii.ac.jp:00003144","sets":["6:7:115:116"]},"author_link":["696","464","268","844","811","6906","812","627","629"],"item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Laparoscopic Omental Patch Closure For Very Elderly Patient with Perforative Peritonitis Due To Gastric Ulcer."}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"チョウ コウレイシャ ノ イカイヨウ ニ ヨル センコウセイ フクマクエン ニ タイシ、フクコウキョウ カ ダイモウ ジュウテン ジュツ ヲ オコナッタ 1レイ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017-03-07","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"59","bibliographicPageStart":"55","bibliographicVolumeNumber":"30","bibliographic_titles":[{"bibliographic_title":"滋賀医科大学雑誌"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"Departmental Bulletin Paper ","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"高齢化と共に超高齢者に対する手術症例も増加している。今回我々は超高齢者の穿孔性腹膜炎に対し、腹腔鏡下に手術を行った１例を経験したので報告する。症例は97歳、女性。主訴は心窩部痛。昼食を摂取後、強い心窩部痛を認め、当院救急外来受診となった。既往歴は大動脈弁狭窄症、狭心症で低用量アスピリン内服中であった。来院時現症は意識清明で、体温は38.1℃、腹部は膨満し、心窩部から上腹部中心に自発痛と圧痛を認め、腹部全体に筋性防御を認め、腸蠕動音は亢進していた。血液検査所見はWBC 8300/μl, CRP 2mg/dlと軽度の炎症反応の上昇を認めた。腹部単純X線写真、右側臥位正面像で腹腔内遊離ガスを認めた。腹部単純CT検査所見では腹腔内遊離ガスと腹水、胃噴門部から胃体上部の壁肥厚を認めた。以上より上部消化管穿孔、汎発性腹膜炎の診断で腹腔鏡下に手術を行った。術中所見では上腹部を中心に混濁した腹水を認め、小腸、大腸、十二指腸に明らかな穿孔部位を認めなかった。胃体上部前壁小弯側に胃壁の肥厚とその中心にpin hole大の小孔を認めた。腹腔鏡下に大網充填術を行った。術後経過は術後3日目からリハビリテーションを開始し、術後5日目より経口摂取を始めた。経過良好で術後23日目に退院となった。本症例では超高齢者の上部消化管穿孔性腹膜炎に対し腹腔鏡下に緊急手術を施行し、術後合併症を認めなかった。積極的な術後リハビリテーションによりADLの低下を認めること無く退院が可能であった。","subitem_description_type":"Other"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"滋賀医科大学雑誌編集委員会"}]},"item_3_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0912-3016","subitem_source_identifier_type":"ISSN"}]},"item_3_version_type_15":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"村本, 圭史"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"三宅, 亨"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"清水, 智治"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"園田, 寛道"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"植木, 智之"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"貝田, 佐知子"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"山口, 剛"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"飯田, 洋也"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"谷, 眞至"}],"nameIdentifiers":[{},{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2017-07-03"}],"displaytype":"detail","filename":"jsums3001p055.pdf","filesize":[{"value":"781.1 kB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"jsums3001p055","url":"https://shiga-med.repo.nii.ac.jp/record/3144/files/jsums3001p055.pdf"},"version_id":"f2d8f99a-872e-4a7a-aa20-8e5cf966ca34"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"汎発性腹膜炎","subitem_subject_scheme":"Other"},{"subitem_subject":"腹腔鏡手術","subitem_subject_scheme":"Other"},{"subitem_subject":"超高齢者","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"超高齢者の胃潰瘍による穿孔性腹膜炎に対し、腹腔鏡下大網充填術を行った1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"超高齢者の胃潰瘍による穿孔性腹膜炎に対し、腹腔鏡下大網充填術を行った1例"}]},"item_type_id":"3","owner":"11","path":["116"],"pubdate":{"attribute_name":"公開日","attribute_value":"2017-07-03"},"publish_date":"2017-07-03","publish_status":"0","recid":"3144","relation_version_is_last":true,"title":["超高齢者の胃潰瘍による穿孔性腹膜炎に対し、腹腔鏡下大網充填術を行った1例"],"weko_creator_id":"11","weko_shared_id":-1},"updated":"2023-06-19T12:27:52.068749+00:00"}