{"created":"2024-02-13T01:18:15.040349+00:00","id":2000784,"links":{},"metadata":{"_buckets":{"deposit":"8adc9f4b-8add-4dd9-a417-26cba30710b7"},"_deposit":{"created_by":17,"id":"2000784","owner":"17","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"2000784"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:02000784","sets":["29:31:1706669033099:1706669223536"]},"author_link":[],"control_number":"2000784","item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Abortive Beh et’s disease with massive bleeding from vaginal ulcer: a case report","subitem_alternative_title_language":"en"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"チツヘキ カイヨウ カラ タイリョウ シュッケツ オ キタシタ フゼンガタ ベーチェットビョウ ノ 1レイ","subitem_alternative_title_language":"ja-Kana"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2024-02-21","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"59","bibliographicPageStart":"54","bibliographicVolumeNumber":"42","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学","bibliographic_titleLang":"ja"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"【背景】　ベーチェット病は口腔粘膜のアフタ性潰瘍、皮膚症状、眼のブドウ膜炎、外陰部潰瘍を主症状とし、急性炎症性発作を繰り返すことを特徴とする疾患である。ベーチェット病の潰瘍病変は腟壁に生ずるのは稀だが、進行すると直腸腟瘻や大量出血を起こし、生命にかかわる可能性がある。疼痛を伴う外陰部潰瘍を認めたため性器ヘルペスとして治療していたが症状が改善せず、腟壁潰瘍病変からの大量出血が契機となり不全型ベーチェット病と診断した１例を経験したため報告する。\n【症例】　44歳、４妊３産。２ヶ月前に外陰部痛を自覚し、性器ヘルペスと診断され、バラシクロビル塩酸塩を内服したが、効果がなかった。その後外陰部痛による歩行困難と排尿障害を認め、さらに大量の性器出血を認めたため当院に救急搬送された。診察上、小陰唇の潰瘍と、腟壁潰瘍から大量の静脈性の出血を認めた。腟壁潰瘍からの出血はガーゼ圧迫により止血し、同日のHb値が5.8g/dLと貧血を認めたため、赤血球輸血を行った。性器ヘルペスを疑い治療したが改善なく、３ヶ月前から反復する口腔内アフタの病歴、前胸部の毛嚢炎の痕から不全型ベーチェット病と診断した。コルヒチン投与にて腟壁潰瘍と外陰部潰瘍、口腔内アフタ、毛嚢炎は改善した。\n【結論】　疼痛を伴う外陰部潰瘍の患者に対し、口腔内アフタや眼症状、皮膚症状など詳細な病歴の聴取による疾患の鑑別が、ベーチェット病の正確な診断と治療につなげることができる。さらに、腟壁潰瘍を伴ったベーチェット病は稀だが、時に大量出血や直腸腟瘻を来す可能性があるため、腟壁を含めた注意深い診察が重要である。","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"names":[{"name":"ナカムラ,フミヒロ","nameLang":"ja-Kana"}]},{"names":[{"name":"ヤマノウチ,ケイコ","nameLang":"ja-Kana"}]},{"names":[{"name":"カネコ,ヒロム","nameLang":"ja-Kana"}]},{"names":[{"name":"オオヌキ,ツヨシ","nameLang":"ja-Kana"}]},{"names":[{"name":"バンザイ,ミチオ","nameLang":"ja-Kana"}]},{"names":[{"name":"ナガセ,サトル","nameLang":"ja-Kana"}]}]},"item_3_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"names":[{"name":"Fumihiro,Nakamura","nameLang":"en"}]},{"names":[{"name":"Keiko,Yamanouchi","nameLang":"ja"}]},{"names":[{"name":"Hiromu,Kaneko","nameLang":"en"}]},{"names":[{"name":"Tsuyoshi,Oonuki","nameLang":"en"}]},{"names":[{"name":"Michio,Banzai","nameLang":"en"}]},{"names":[{"name":"Satoru,Nagase","nameLang":"en"}]}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.15022/0002000784","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"山形大学","subitem_publisher_language":"ja"}]},"item_3_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0288-030X","subitem_source_identifier_type":"ISSN"}]},"item_3_source_id_9":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00067279","subitem_source_identifier_type":"NCID"}]},"item_3_text_33":{"attribute_name":"出版者（ヨミ）","attribute_value_mlt":[{"subitem_text_language":"ja","subitem_text_value":"ヤマガタ 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aphthae","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":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"腟壁潰瘍から大量出血をきたした不全型ベーチェット病の一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"腟壁潰瘍から大量出血をきたした不全型ベーチェット病の一例","subitem_title_language":"ja"}]},"item_type_id":"3","owner":"17","path":["1706669223536"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2024-02-21"},"publish_date":"2024-02-21","publish_status":"0","recid":"2000784","relation_version_is_last":true,"title":["腟壁潰瘍から大量出血をきたした不全型ベーチェット病の一例"],"weko_creator_id":"17","weko_shared_id":-1},"updated":"2024-04-11T03:54:03.083295+00:00"}