以急性腹痛為最初表現的脊髓硬膜外海綿狀血管瘤：一病例報告

Acute Abdominal Pain as the Initial Manifestation of Spinal Epidural Cavernous Hemangioma: A Case Report

脊髓硬膜外海綿狀血管瘤是罕見的疾病，回顧文獻並無以急性腹痛為最初表現之報告。我們提出一位以急性腹痛為脊髓硬膜外海綿狀血管瘤最初表現之病例報告。病人為67歲女性，在家中突然感到上腹疼痛，三小時後合併下肢無力。胸椎磁振造影懷疑第九至第十一胸椎硬膜外海綿狀血管瘤合併血管瘤破裂。經手術後，切片證實是海綿狀血管瘤破裂，病患在術後三週可獨立行走。脊髓的問題以腹痛為最初表現的情形並不常見，但臨床上仍應提高警覺，以期早期診斷與治療。

Spinal epidural cavernous hemangioma is a rare disease. To our knowledge, there was no report mentioning acute abdominal pain as the initial symptom of spinal epidural cavernous hemangioma. We presented one case of spinal epidural cavernous hemangioma with initial symptom of acute abdominal pain. A 67-year-old female with history of sudden onset of acute abdominal pain and followed by bilateral lower limb weakness 3 hours later. Magnetic Resonance Image (MRI) suggested epidural cavernous hemangioma with rupture. Pathology confirmed this diagnosis. Postoperatively, the patient recovered rapidly. She can walk independently 3 weeks after the operation. In conclusion, spinal cord problem with abdominal pain as the initial presentation is rare, but for early diagnosis and treatment it should be considered in patients who present with abdominal pain in the first place.