御嶽山噴火による噴石外傷の経験(An experience of trauma cases: patients hit by rocks during the Mt Ontake volcanic eruption in Japan)

Abstract

2014年9月27日午前11時52分に御嶽山が噴火し，山頂付近にいた多くの登山者が被災した。岐阜県側の山頂山小屋に負傷者を含む26名の登山者が避難したため，翌朝DMATと山岳救助隊が傷病者救出活動を実施した。被災者のうち，重症者1名，中等症者2名をヘリ搬送し当院に収容した。症例1：39歳女性。左鎖骨・肋骨・肩甲骨開放骨折を受傷しており，全身麻酔下にデブリドマンを施行した。症例2：52歳男性。左上腕骨開放骨折を受傷しており，洗浄・固定術を施行した。症例3：46歳男性。左体幹部に広範な打撲による皮下血腫，腫脹と高CK血症を認めた。3例とも高速飛来物に起因する鈍的外傷および穿通損傷であり，損傷形態は二次あるいは四次爆傷と考えられた。比較的まれな火山噴火による噴石外傷を経験したので報告する。Mt. Ontake erupted at 11:52 am on September 27, 2014, and many climbers who happened to be on the mountain were killed or injured. Early the next morning, a Disaster Medical Assistance Team and Mountain Rescue Team carried out rescue and first aid operations for a group of 26 climbers who had been evacuated to a cabin located on the highest summit in Gifu Prefecture. Of the climbers, 3 who required medical treatment were transported by helicopter to our hospital. Case 1: A 39–year–old female had open fractures of the left clavicle, scapula, and ribs and underwent debridement under general anesthesia. Case 2: A 52–year–old male had an open fracture of the left humerus and underwent irrigation and fixation. Case 3: A 46–year–old male had serious bruising and swelling on the left side of his body due to extensive contusions with high serum levels of creatine kinase. All the patients had blunt injuries and penetrating injuries that were classified as secondary or quaternary blast injuries caused by the impact of high–velocity fragments of volcanic rock, debris and gas. We report here a rare experience with blast injuries caused by a volcanic eruption in Japan.