8/16/2019 Acute Occlusion of Abdominal Aorta

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Acute Occlusion of Abdominal Aorta: a case report

Laforteza, Pearl Margaret; Listanco, Olivia Faye; Mercado, Genesis

Abstract:

A!" #"PO#$

A %& year old 'ypertensive non(smo)er female Filipino *it' c'ronic atrial +brillation

*as admitted to our 'ospital for rig't leg pain $'e patient 'ad a t'ree day 'istory

of rig't leg pain described as dull and steady, associated *it' bipedal edema and

di-culty in ambulation !'e t'en soug't consult at a local 'ospital given

Furosemide and pain medications Medications provided slig't resolution of bipedal

edema 'o*ever pain persisted !'e t'en soug't anot'er consult to anot'er

'ospital, *'ere .oppler ultrasound of t'e lo*er e/tremities s'o*ed occlusion of t'e

rig't popliteal artery Patient *as managed as a case of acute limb isc'emia

0nitially given 1&&& unit of 'eparin bolus intravenously and started on 'eparin drip

at 1&& unit2'our and transferred to our intuition Patient *as manged as a case

acute lim isc'emia stage 000 3er p'ysical e/aminations revealed cold to touc' rig't

an)le and foot *it' decreased rig't femoral pulse and absent rig't popliteal and

dorsalis pedis pulses Left leg *as *arm and *it' strong to moderate femoral,

popliteal and dorsalis pedis pulses 4o e/ternal lesion or cyanosis *as reported

ontrast(en'anced M# angiograp'y of t'e abdominal aorta to t'e lo*er e/tremitiesrun(o5 revealed severe stenosis involving t'e distal abdominal aorta inferior to t'e

inferior mesenteric artery e/tending to t'e aorto(iliac bifurcation and pro/imal iliac

arteries bilaterally Mar)ed complete or severe stenosis *as noted pro/imal rig't

common iliac artery Moderate to severe stenosis of t'e pro/imal left common iliac

artery and severe stenosis involving t'e rig't super+cial rig't femoral arter amd

moderate occlusion at t'e popliteal artery *ere described

0mmediate relief of t'e occlusion *as performed *it' bilateral femoral e/ploration,

a/illo(femoral t'rombolectomy, rig't femoral edarterctomy, vein patc' repair of

bilateral femoral artery and above t'e )nee amputation on t'e rig't leg 3eparin

drip *as titrated accordingly based on t'e serial determination of t'e partialprot'rombin time and *as discontinued 6 'ours prior to t'e operation Post

operatively 'eparin drip *as continued at 7&& unit2 'our and *as titrated based og

t'e partial prot'ronbin time, and eventually overlap *it' *arfarin *as started and

drip *as discontinued

0ncidental +nding of a 'ypodense focus *it' necrotic center *as also noted on t'e

+rst M#A 'ence a follo* up *as done, *'ic' revelead 8888888888888

8/16/2019 Acute Occlusion of Abdominal Aorta

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