RESUMO
We present two cases of segmental arterial mediolysis, which can present with dissecting aneurysms or thrombosis of the visceral branches of the abdominal aorta. Segmental arterial mediolysis (SAM) causes ischemic bowel disease and has characteristic CT and angiographic features.
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Background. Acute limb ischaemia is threatening to both limb and life. There is little information about this disease entity from India. Methods. We did a retrospective analysis of the clinical profile of patients presenting with non-traumatic acute limb ischaemia to our department (a tertiary care centre in India) from January 1998 to December 2007. The demography, risk factors, time taken to present to the emergency from the onset of symptoms, time taken to administer the first dose of heparin upon arrival to the emergency, primary interventions and outcomes in terms of amputation rates and in-hospital mortality were studied. Results. The mean (SD) age of the 84 patients was 48.9 (14.3) years. Only one patient died (1.2%) and 24 patients had an amputation (28.6%). Among the predisposing risk factors a significant association was found between smoking and the rate of amputation. Early presentation to emergency and early administration of heparin was associated with lower amputation rates though this did not achieve statistical significance. Conclusion. Acute limb ischaemia is a catastrophic event. Smoking is a risk factor associated with poorer outcomes. Early arrival to the emergency and early administration of heparin was associated with lower amputation rates.
Assuntos
Doença Aguda , Amputação Cirúrgica , Anticoagulantes/uso terapêutico , Anticoagulantes/uso terapêutico , Heparina/uso terapêutico , Humanos , Isquemia/cirurgia , Perna (Membro)/irrigação sanguínea , Perna (Membro)/cirurgia , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/cirurgia , Fatores de Risco , Fatores de TempoRESUMO
Ileosigmoid intussusception can lead to ischemia and necrosis of either the ileum or sigmoid colon. Ileosigmoid intussusception as a mass prolapsing per rectum in an adult has not been previously reported. We report a 50-year-old man with such a presentation. He recovered uneventfully after subtotal colectomy.