Acute Limb

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acute limb ischemia

Transcript of Acute Limb

  • 1

    2

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    (ACU

    TE LO

    WER

    LIMB

    ISCHE

    MIA)

    1-3

    3

    4

    1.

    (int

    ralum

    inal

    occlus

    ion)

    (acu

    te art

    erial

    embo

    lism)

    (e

    ndolu

    mina

    l arte

    rial i

    njury)

    (t

    hromb

    osed

    aneu

    rysm)

    (

    1-1)

    2.

    (int

    ramur

    alocc

    lusion

    )

  • 3

    (

    acute

    arter

    ial th

    rombo

    sis,

    athero

    throm

    bosis

    )

    (fu

    ngal

    arteri

    tis, P

    ythios

    is)

    (a

    ortic

    dissec

    tion)

    ( 1

    -2)3.

    (extra

    mural

    occlus

    ion)

    (a

    rteria

    l inju

    ry)

    (

    1-3)

    .

    1-1

    .

    1-2

    .

    .

    .

    .

    4

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    (ar

    terial

    spasm

    )

    er

    got

    (ph

    legma

    sia ce

    rulea

    dolen

    s)

    (lo

    w flo

    w sta

    te)

    .

    1-3

    .

    .

  • 5

    5-11

    1.

    (p

    aresth

    esia)

    (

    analg

    esia)

    (intrin

    sic m

    uscle

    s of fo

    ot)

    (pares

    is)

    (pa

    ralysi

    s)

    2.

    (pa

    llor)

    (po

    ikilot

    herm

    ia)

    (

    skin m

    ottlin

    g)

    (fix

    edsta

    ining

    skin)

    (ga

    n-gre

    ne)

    3.

    6

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    (

    muscl

    e ten

    derne

    ss)

    (m

    uscle

    rigor)

    (re

    perfu

    sion i

    njury)

    6-11

    (to

    xemi

    a)

    (m

    ultior

    gan

    failur

    e)

  • 7

    1.

    (

    arteri

    al em

    bolis

    m)12

    (

    1

    -4)

    .

    . 200

    813

    .. 2

    543

    .. 2

    547

    91

    2.2:10

    ,000

    2

    ca

    rdioa

    rteria

    l embo

    lism

    art

    erio-

    arteri

    al em

    bolism

    14

    1

    5-23

    atrial

    fibri

    llatio

    n

    (atria

    l myx

    oma)

    a

    trial

    fibrill

    ation

    1-4

    8

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    (left

    atrium

    )

    (l

    eft v

    entric

    le)

    (m

    ural t

    hromb

    us)

    (ve

    ntricu

    lar an

    eurys

    m)

    (ane

    urysm

    )24,25

    (

    athero

    -scl

    erosis

    oblite

    rans)2

    6,27

    (

    1-5

    )

    (

    1-

    6)

    (mi

    croem

    boli)

    (blue

    toe)2

    8,29

    (g

    angre

    nous

    toe)

    ( 1

    -7)

    p

    arado

    xical e

    m-bo

    lism30,

    31

    32

    (poly

    cythe

    mia)

    (leu-

    cocy

    tosis)

    (thro

    mboc

    ytosis

    )

    (natu

    ral an

    ticoa

    gulan

    ts)

    (pr

    otein

    C)

    (prote

    in S)

  • 9

    1-5

    (ab

    domi

    nal u

    ltra-

    sonog

    raphy

    )

    1-7

    (

    gang

    renou

    stoe

    )

    1-6

    (ec

    hoca

    rdio g

    raphy

    )(

    :

    -

    )

    10

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    .

    . 200

    813

    91

    atria

    l fibri

    llation

    29

    (

    31.9)

    11

    (

    1

    2.1)

    11

    (

    12.1

    )

    3

    (

    3

    .3)

    2

    (

    2.2)

    1

    (

    1.1)

    15

    (

    16.5

    )

    45

    (

    4

    9.5)

    2.

    (a

    cute

    arte-

    rial th

    rombo

    sis, a

    therot

    hromb

    osis)

    (ath

    eroscl

    erosis

    obli

    teran

    s)

    (a

    therom

    atous

    plaq

    ue ru

    pture)

    33 (

    1-8)

    (collat

    eral

  • 11

    circu

    lation

    )

    .

    . 200

    934

    .

    . 2543

    .

    . 2547

    29

    7

    2

    1

    (

    72.4

    )

    1

    6

    (

    55.2

    )

    13

    (

    44.8

    )

    11

    (

    3

    7.9)

    3.

    (art

    erial

    injury

    )

    2

    1- 8

    ( :

    )

    12

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    3

    35

    36

    -38

    39

    40

    -44

    (To

    urniqu

    et)

    (intim

    al inj

    ury)

    (intr

    amura

    l contu

    sion)

    (arte

    rial tr

    ansec

    -tio

    n)

    fe

    moral

    femo

    ral

    popli

    teal

  • 13

    4.

    (thr

    om-

    bosed

    aneu

    rysm)

    45-51

    po

    plitea

    l (

    1-9)

    1-9

    pop

    liteal

    ( :

    )

    14

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    fe

    moral

    ili

    ac

    a

    bdom

    inal a

    orta

    po

    plitea

    l

    35

    52

    53

    (c

    athete

    r-dire

    cted

    throm

    bolys

    is)

    14

    popli

    teal

    43

    48

    59

    5.

    (fu

    ngal

    arteri

    tis)

    Pyth

    ium in

    sidios

    um

    .

    . 1996

    54

    55-59

  • 15

    33

    3

    6

    T

    halas

    semia

    3

    (c

    utane

    ous i

    nfecti

    on)

    (oc

    ular i

    nfecti

    on)

    (syst

    emic

    or va

    scula

    r infe

    ction

    )

    (ne

    crotiz

    ing a

    rterit

    is)(

    1-10

    )

    1-10

    Pythi

    um in

    sidios

    um

    (

    :

    )

    16

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    6.

    (ao

    rtic d

    issect

    ion)

    2

    60,61

    (as

    cend

    ing th

    oracic

    aorta

    )

    (Stan

    dford

    type A

    )

    (S

    tandfo

    rd typ

    e B) (

    1-

    11)

    62,63

    7.

    (dru

    g ind

    uced

    arte

    rial

    spasm

    )

    e

    rgotam

    inetar

    trate

    (cafer

    got)6

    4,65

    migra

    ine

  • 17

    8.

    (phle

    gmasi

    a ceru

    lea do

    lens)

    il

    iac

    1-11

    )

    (Stan

    dford

    type A

    ) )

    (Stan

    dford

    type B

    )

    18

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    fem

    oral

    9.

    (circ

    ulator

    y fail

    ure)

    (low

    flow

    state)

    (acute

    graft

    throm

    bosis

    )

    1.

    1.1

    (leg

    pain

    )

    1.2

    (pall

    or an

    d po

    ikilot

    herm

    ia)

  • 19

    (top

    ograp

    hic pa

    ttern)

    1.3

    (pares

    thesia

    )

    (ana

    lgesia

    )

    1.4

    (p

    aresis

    )

    (intri

    nsic

    musc

    les)

    (ab

    ducti

    on an

    d add

    uctio

    n)

    (p

    aralys

    is)

    6

    1.5

    (puls

    elessn

    ess)

    2.

    2.1

    (

    skin

    mottli

    ng) (

    1-12)

    20

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    (fix

    ed st

    aining

    skin)

    (lin

    e of d

    emarc

    ation

    ) (

    1-13)

    2.2

    (

    muscl

    e ten

    derne

    ss)

    (

    muscl

    e rigo

    r) (

    1-14

    )2.3

    1-12

    (sk

    in mo

    t-tlin

    g)

    1-13

    (lin

    eof

    dema

    rcatio

    n)

  • 21

    2.3.1

    (m

    yoglo

    -bin

    ) (

    1-1

    5)

    2.3

    .2

    (

    1-16

    )2.3

    .3

    sup

    erior

    mesen

    teric

    1-14

    (mus

    clerig

    or)

    22

    Acute

    Low

    er Li

    mb Is

    chem

    ia

    .. 20

    1067

    s

    uperi

    or me

    -sen

    teric

    3.

    3.1

    (pe

    riphe

    ral pu

    lse pa

    lpatio

    n)

    1-

    1

    1-15

    (

    myog

    lobinu

    ria)

    1-16

  • 23

    3.2

    (ar

    ea o

    f pale

    and

    poik

    ilo-

    therm

    ia)

    (to

    pogra

    phic

    patte

    rn)

    1-17

    4.

    2

    (rev

    ersibl

    e isch

    emia)

    (irre-

    versi

    ble is

    chem

    ia)

    3

    (

    mild

    ische

    mia)

    (mod

    erate

    ische

    mia)

    (se

    vere

    ische

    mia)

    4.1

    (p

    ain)

    (pa

    le an

    d poik

    ilothe

    mia)

    1-1

    fem

    oral

    popli

    teal

    poste

    rior t

    ibial

    dorda

    lis pe

    disab

    domi

    nal a

    ortic

    bifurc

    ation

    0*0*

    0*0*

    iliac b

    ifurca

    tion

    00

    00

    femora

    l bifu

    rcatio

    n++

    00