ABSTRACT
Buerger's disease is an inflammatory non atheromatous distal arteriopathy affecting mainly young male smokers. There is some controversy about the existence of visceral localisations of the disease. Raport a new case. We report the case of a 40 years old man who developed a Budd Chiari syndrome with thromboses of the right hepatic venous, Later, he presented with rheumatic and distal occlusive arterial manifestations diagnosed as Buerger's disease. We underline the fact that digestive manifestations and hepatic involvement are less known and sometimes misdiagnosed
Subject(s)
Humans , Male , Thromboangiitis Obliterans/diagnosisSubject(s)
Adult , Humans , Leg/blood supply , Magnetic Resonance Angiography , Male , Thromboangiitis Obliterans/diagnosisABSTRACT
La tromboangeitis obliterante (TAO) o enfermedad de Buerger ha sido considerada una forma de vasculitis relacionada etiológicamente con el hábito tabáquico. De acuerdo a la revisión de la literatura, no existen estudios previos acerca del compromiso muscular en esta enfermedad, esto nos estimuló a reportar el caso de un paciente afectado de la mencionada patología y con signos clínicos evidentes de alteración muscular. Por ese motivo, se realizó biopsia muscular por punción percutánea, con aguja tipo Bergstrom, del músculo cuadriceps femoris. Se procesaron las muestras por métodos convencionales para microscopía electrónica de transmisión. De acuerdo a los resultados ultraestructurales, las alteraciones que se producen en los capilares intramusculares son de tipo isquémico. Igualmente, la presencia de atrofia nos señala un posible daño neural en esta enfermedad. Algunas de las alteraciones observadas en los capilares y en relación con el infiltrado presente podrían sugerir un componente autoinmune en la etiología de la enfermedad
Subject(s)
Humans , Male , Adult , Muscles/ultrastructure , Thromboangiitis Obliterans/diagnosis , Thromboangiitis Obliterans/physiopathology , Biopsy, Needle , Electromyography/methods , Microscopy, Electron/methods , Muscular Atrophy/etiology , Photomicrography , Smoking/adverse effects , Thromboangiitis Obliterans/immunologyABSTRACT
Objetivos. Conocer las características clínicas de la presentación de la enfermedad de Buerger en el Hospital San Juan de Dios de Santa Fe de Bogotá
Subject(s)
Humans , Thromboangiitis Obliterans , Thromboangiitis Obliterans/diagnosis , Thromboangiitis Obliterans/etiology , Thromboangiitis Obliterans/physiopathology , Thromboangiitis Obliterans/therapyABSTRACT
A 27-year-old man with a diagnosis of Buerger's disease presented with vasospastic symptoms of coldness and pain at rest of his right foot. Physical examination of his affected limb revealed absent popliteal pulse, cool skin hyperhidrosis and dry gangrene of the big toe. He had been operated on for a ruptured liver and liver abscess 20 years ago. He was scheduled for totally extraperitoneal laparoscopic lumbar sympathectomy on July 26, 1994. The technique was performed under general anesthesia and the patient was put in a supine position with slight extension between the rib and the iliac crest. The working space was created by digital blunt dissection and direct insufflation of carbon dioxide. The right sympathetic trunk was found between the medial edge of the psoas muscle and inferior vena cava. The L2, L3, L4 sympathetic ganglia were identified above the vertebral column and meticulously dissected cephalocaudally. Based on the concept of traditional approach, we believe that this laparoscopic technique is relatively safe and should become the procedure of choice in the future.
Subject(s)
Adult , Humans , Laparoscopy/methods , Lumbosacral Plexus/surgery , Male , Sympathectomy/methods , Thromboangiitis Obliterans/diagnosis , Wound Healing/physiologyABSTRACT
Os autores apresentam um caso de isquemia mesentérica aguda em paciente portador de tromboangiitr obliterante. Discutem a raridade do comprometimento intestinal na doença em questäo, assim como as formas de diagnosticá-la