{"created":"2023-06-20T15:48:51.357756+00:00","id":3385,"links":{},"metadata":{"_buckets":{"deposit":"a6f3e78e-9fd6-41e6-b7d7-21a59e3ac441"},"_deposit":{"created_by":4,"id":"3385","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"3385"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00003385","sets":["1:12:68"]},"author_link":["9953","9954","9955","9956","9957","9958","9959","9960","9961"],"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"109","bibliographicPageStart":"101","bibliographicVolumeNumber":"8","bibliographic_titles":[{"bibliographic_title":"静岡産科婦人科学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"母体横隔膜ヘルニア合併妊娠はまれであり、非特異的な症状や身体所見から早期診断に苦慮する病態だが、系統的診察や画像検査により診断できるため、入念な全身評価が肝要である。妊娠前より空腹時や過食時に心窩部痛を自覚していた34歳の初妊婦が、症状が増悪したため妊娠25週4日に受診した。腹部超音波・心電図・胎児心拍数モニタリング・血液検査では特記すべき異常所見を認めなかった。症状不変のため妊娠26週0日に再評価した際、横隔膜弛緩症の既往と左呼吸音の減弱が判明した。胸部単純X線で、左胸腔内の二ボーと左肺の圧排虚脱と縦隔の右側偏位、そして胸部単純Computed Tomography (CT) で、胃や横行結腸・膵体尾部・脾臓の胸腔内への脱出を認めた。以上の画像所見より横隔膜ヘルニアと診断した。保存的に妊娠継続を図り、妊娠32週5日に帝王切開し、術後第15病日に腹腔鏡下ヘルニア修復術を行った。原因不明の病態については基本に立ち返って全身評価することが早期診断に有用であることを訓戒としてあらためて示された症例であった。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Diaphragmatic hernia in pregnancy is a rare condition and early diagnosis is difficult owing to its non-specific symptoms and physical findings. However, it can be detected by thorough whole-body evaluation, such as systemic examination and imaging.A 34-year-old primigravid woman who often experienced epigastric pain when hungry or after overeating before pregnancy presented to our hospital at 25 weeks and 4 days of pregnancy due to exacerbation of the symptom. No abnormality was found by abdominal ultrasound, electrocardiogram, fetal heart rate monitoring, or blood test. When re-evaluated at 26 weeks and 0 days of pregnancy due to persistence of the symptom, the patient was found to have a history of diaphragmatic relaxation and diminished breath sounds in her left chest. Plain chest X-ray revealed a niveau formation in the left pleural cavity, atelectasis of the left lung, and mediastinal displacement to the right. Plain chest computed tomography revealed prolapse of organs including the stomach, transverse colon, pancreas tail, and spleen into the pleural cavity. The patient was diagnosed with diaphragmatic hernia and managed with conservative treatment to continue the pregnancy. C-section was performed at 32 weeks and 5 days, and laparoscopic hernia reparative surgery was performed 15 days after delivery. Thus, this case indicates that performing whole-body evaluation is useful for early diagnosis of unexplained illness.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"静岡産科婦人科学会","subitem_publisher_language":"ja"}]},"item_3_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"21871914","subitem_source_identifier_type":"ISSN"}]},"item_3_version_type_32":{"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":"戎野, 志織","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"堀越, 義正","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"伊東, 宏晃","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"川合, 健太","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"幸村, 友季子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"磯村, 直美","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"内田, 季之","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"鈴木, 一有","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"金山, 尚裕","creatorNameLang":"ja"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-03-26"}],"displaytype":"detail","filename":"jsog_8_1_101.pdf","filesize":[{"value":"1.2 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsog_8_1_101","url":"https://hama-med.repo.nii.ac.jp/record/3385/files/jsog_8_1_101.pdf"},"version_id":"7684e950-b957-44d4-b498-67cfa1e08a1e"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Pregnancy","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Diaphragmatic hernia","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Diaphragmatic relaxation","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Laparoscopic hernia reparative surgery","subitem_subject_language":"en","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":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"系統的診察の有用性が示唆された母体横隔膜ヘルニア合併妊娠の1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"系統的診察の有用性が示唆された母体横隔膜ヘルニア合併妊娠の1例","subitem_title_language":"ja"},{"subitem_title":"Maternal diaphragmatic hernia in pregnancy diagnosed by systemic examination: a case report","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["68"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2019-03-26"},"publish_date":"2019-03-26","publish_status":"0","recid":"3385","relation_version_is_last":true,"title":["系統的診察の有用性が示唆された母体横隔膜ヘルニア合併妊娠の1例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-01T06:56:03.115252+00:00"}