scholarly journals An uncommon case of acute lower limb ischemia

2019 ◽  
Vol 13 (3) ◽  
pp. 185-186
Author(s):  
Maria Viviana Carlino ◽  
Paola Ieranò ◽  
Mario Venafro ◽  
Claudia Sara Cimmino ◽  
Costantino Mancusi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Lower Limb ◽  
Plaque Rupture ◽  
Abdominal Mass ◽  
Signs And Symptoms ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Computed Tomographic ◽  
Lower Limb Pain ◽  
The Impact

We describe a case of a 76-year-old woman who presented to the Emergency Department with right lower limb pain after a fall. One hour after the admission to the Emergency Department, the patient presented all the signs and symptoms of acute limb ischemia. The patient underwent contrast-enhanced computed tomographic scan of abdomen and right lower limb that showed a large abdominal lesion suggestive of ovarian cancer compressing the right common iliac artery and a visible thrombus and ruptured plaque in this artery. We hypothesized that the acute limb ischemia caused by thrombosis in situ arose from acute plaque rupture probably due to the impact of the large abdominal mass on the artery during patient’s fall.

Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis – case report and systematic review of dabigatran use

VASA ◽  
2020 ◽  
pp. 1-6 ◽  
Author(s):  
Marina Di Pilla ◽  
Stefano Barco ◽  
Clara Sacco ◽  
Giovanni Barosi ◽  
Corrado Lodigiani
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Review Of The Literature ◽  
Heparin Induced Thrombocytopenia ◽  
Lower Limb Ischemia ◽  
Vein Thrombosis ◽  
Left Lower Limb

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

scholarly journals A case of acute limb ischemia

2021 ◽  
Vol 8 (10) ◽  
pp. 1608
Author(s):  
Kshiti Rai ◽  
K. G. Sajeeth Kumar ◽  
Danish Ekkalayil ◽  
Anoop Chanthu K. K.
Keyword(s):  
Acute Myeloid Leukemia ◽  
Early Diagnosis ◽  
Lower Limb ◽  
Myeloid Leukemia ◽  
Hematological Malignancy ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Rare Presentation ◽  
Hematological Evaluation ◽  
Acute Myeloid

Thromboembolism is a well-recognized complication of hematological malignancy. The incidence of symptomatic thrombosis at diagnosis is relatively low in AML (acute myeloid leukemia) patients, though its incidence increases on treatment with anthracyclines. We reported a case of 69 year old female with T2DM who presented with DVT and later on acute limb ischemia of the same lower limb. On hematological evaluation, she had leukocytosis and thrombocytopenia. Further evaluation revealed AML. Thromboembolism as a rare presentation of AML in adults with leukemic hyperleukocytosis has seldom been reported. In the absence of clear guidelines, early diagnosis and management are desirable.

The impact of prolonged lower limb ischemia on amputation, mortality, and functional status: The FRIENDS registry

2014 ◽  
Vol 168 (4) ◽  
pp. 577-587 ◽  
Author(s):  
Sue Duval ◽  
Hong H. Keo ◽  
Niki C. Oldenburg ◽  
Iris Baumgartner ◽  
Michael R. Jaff ◽  
...  
Keyword(s):  
Functional Status ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
The Impact

scholarly journals Acute Lower Limb Ischemia Secondary to COVID-19: A Case Report

2021 ◽  
Vol 11 (6) ◽  
pp. 161-163
Author(s):  
Komal Gharsangi ◽  
Rajesh Bhawani ◽  
Nitesh Kumar
Keyword(s):  
Lower Limb ◽  
Distress Syndrome ◽  
Multiorgan Failure ◽  
Clinical Manifestations ◽  
Limb Ischemia ◽  
Respiratory Illness ◽  
Acute Limb Ischemia ◽  
Poor Clinical Outcome ◽  
Rare Manifestation ◽  
Thrombotic Complications

COVID -19 is not just a respiratory illness; it is a great masquerader with clinical manifestations from pneumonia, acute respiratory distress syndrome to endothelial dysfunction, hypercoagulability and multiorgan failure. Thrombotic complications due to Covid related coagulopathy is of concern as it further leads to poor clinical outcome in severe cases of Covid 19. Acute limb ischemia (ALI) is a rare manifestation of Covid related coagulopathy. Key words: COVID, coagulopathy, acute limb ischemia (ALI).

scholarly journals Analgesia for extremity fractures in the paediatric emergency department

2020 ◽  
Vol 29 (2) ◽  
pp. 108-112
Author(s):  
Siew Ming Tan ◽  
Yong-Kwang Gene Ong ◽  
Jen Heng Pek
Keyword(s):  
Emergency Department ◽  
Pain Score ◽  
Lower Limb ◽  
Key Management ◽  
Current Practice ◽  
Paediatric Emergency Department ◽  
Patient Demographics ◽  
Paediatric Emergency ◽  
The Mean ◽  
The Impact

Background: Extremity fractures are an important and common presentation at the Paediatric Emergency Department (PED). Provision of analgesia is a key management principle, but it is often suboptimal. Although there is an increase in awareness of this issue, the impact on current practice is not known. We aimed to review the current practice of providing analgesia for extremity fractures in the PED. Objective: Our objective was to determine the utilisation, adequacy and timeliness of analgesia provided for these patients. Methods: A retrospective study was carried out from November to December 2017. Patients with a diagnosis of extremity fracture involving the upper or lower limb were included. Information about patient demographics, diagnosis, pain score, analgesia use and clinical progress were collected for analysis. Results: There were 101 cases. The mean age was 8.5±4.2 years old, and 62 (61.4%) patients were male. There were 76 (75.3%) cases of fractures involving the upper limb, and 25 (24.7%) cases of fractures involving the lower limb. The mean pain score at presentation was 3.3±2.3. Analgesia was administered to only 10 (9.9%) patients, with oral paracetamol ( n=5; 5.0%) being the most common medication administered. The median time between arrival in the PED to analgesia administration was 69 minutes (range 25–328 minutes). Conclusions: Despite the increase in awareness, analgesia for these patients remains underutilised, inadequate and delayed. Further efforts at pain assessment, analgesia selection and administration are necessary to improve the provision of analgesia for these patients.

Consideration of pulmonary thromboembolism in paediatric patients presenting to the emergency department with abdominal pain

2021 ◽  
Vol 14 (5) ◽  
pp. e239175
Author(s):  
Wasyla Ibrahim ◽  
Farhat Mushtaq
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Lower Limb ◽  
Pulmonary Thromboembolism ◽  
Signs And Symptoms ◽  
Paediatric Population ◽  
Limb Trauma ◽  
High Index Of Suspicion ◽  
Lower Limb Trauma

Venous thromboembolism (VTE) is a recognised complication of lower limb trauma in adult patients and classically presents with cardiopulmonary symptoms. However, the risk of VTE and its presenting signs and symptoms are less well documented in the paediatric population. We report the case of a child who presented to our emergency department with abdominal pain 2 weeks after lower limb fracture, who was subsequently found to have a pulmonary thromboembolism (PTE). This case report highlights the importance of having a high index of suspicion for VTE in the paediatric population if there are predisposing risk factors and to consider PTE as a differential cause of abdominal pain. To the authors’ knowledge, no case has been described in which a child presenting with abdominal pain was consequently found to have a pulmonary embolism.

scholarly journals 3480 Association of Clopidogrel Resistance Determinants and MACE Ocurrence in Peripheral Arterial Disease

2019 ◽  
Vol 3 (s1) ◽  
pp. 34-34
Author(s):  
Hector Jose Nunez Medina
Keyword(s):  
Puerto Rico ◽  
Antiplatelet Therapy ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Standard Test ◽  
Major Adverse Cardiovascular Events ◽  
Acute Limb Ischemia ◽  
Clopidogrel Resistance ◽  
Cyp2c19 Polymorphism ◽  
The Impact

OBJECTIVES/SPECIFIC AIMS: The study aims to identify the short and long-term associations of HTPR and presence of CYP2C19 polymorphism in the occurrence of major adverse cardiovascular events (MACE). The primary outcome of the study will be the presence of MACE including stent thrombosis, need for revascularization, acute limb ischemia events, myocardial infarction and death in relation to the presence of HTPR and CYP2C19 polymorphism. Secondary outcomes will include the prevalence of HTPR and CYP2C19 polymorphism in patients with PAD, and association with other medications including aspirin and cilostazol. METHODS/STUDY POPULATION: Patients above 21 years of age with the diagnosis of PAD using clopidogrel therapy for at least for seven days will be recruited at the University of Puerto Rico District Hospital and Cardiovascular Hospital of Puerto Rico and the Caribbean. RESULTS/ANTICIPATED RESULTS: A total of 200 patients from Puertorrican, Dominican and Cuban ethnicity will be expected to be recruited. The most common comorbidities will include, coronary artery disease, hypertension, dyslipidemia, and diabetes mellitus type 2. No significant distr DISCUSSION/SIGNIFICANCE OF IMPACT: The status quo as it pertains to resistance to clopidogrel in PAD patients is to improve antiplatelet resistance using antiplatelet therapy guided by platelet assays in order to reduce MACE occurrence. Although HTPR and presence of CYP2C19 polymorphisms have been studied on the PAD population, currently there is no gold standard test for measuring antiplatelet resistance. In that regard, this study will expect to identify the contribution that HTPR and CYP2C19 polymorphism might have on MACE in patients with PAD. In this way, the results will allow identification of abnormality parameters in HTPR and CYP2C19 testing in relation to the impact on risk of having MACE. Once the association of these variables with MACE is established, testing for clopidogrel resistance could become a potential strategy to optimize antiplatelet therapy and reduce the impact that MACE have in this population.

scholarly journals Acute Aortic Occlusion with Acute Onset of Paraplegia and Severe Hyposthenia

2020 ◽  
pp. 1-3
Author(s):  
Stefania Tamburrini ◽  
Daniela Viola ◽  
Fabio Spinetti ◽  
Giuseppe Mercogliano ◽  
Giuseppe Sarti ◽  
...  
Keyword(s):  
Lower Limb ◽  
Mesenteric Artery ◽  
Limb Ischemia ◽  
Acute Onset ◽  
Lower Limbs ◽  
Motor Deficit ◽  
Acute Limb Ischemia ◽  
Neurological Assessment ◽  
Bilateral Lower Limb ◽  
Acute Aortic Occlusion

A 75-years-old man presented at our ED with acute onset of paraplegia and severe bilateral lower limb hyposthenia. The patient ‘s neurological assessment was negative except for lower limbs positive Mingazzini test. CT angiography detected a complete lack of opacification of the abdominal aorta immediately below the emergency of the inferior mesenteric artery, caused by a coarse thrombus in the left ventricle. We present a case of acute aortic and lumbar arteries thrombosis with paraplegia and no clear symptoms of acute limb ischemia, in which the motor deficit in the lower extremities was explained by anterior spinal cord syndrome secondary to acute occlusion of lumbar arteries.

Aortic plaque rupture in the setting of acute lower limb ischemia

2010 ◽  
Vol 200 (4) ◽  
pp. e51-e52
Author(s):  
David H. O'Donnell ◽  
Michael A. Moloney ◽  
Ronan P. Killeen ◽  
Stephen Sheehan ◽  
David P. Brophy
Keyword(s):  
Lower Limb ◽  
Plaque Rupture ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Aortic Plaque
Sign in / Sign up

Export Citation Format

Share Document