Acute lower limb ischaemia secondary to intestinal occlusion

Abstract

In general, acute lower limb ischaemia is caused by embolic, thrombotic or traumatic phenomena. Here, we describe the case of a 67-year-old woman in an emergency room setting who was initially assessed for paralysis and numbness of her lower left limb. On physical examination, the abdomen was distended and non-compressible. An abdominal AngioScan showed complete occlusion of the left iliac artery by extrinsic compression of the dilated small intestine. After a review of the literature, no case was found describing a lower limb ischaemia by extrinsic vascular compression secondary to a compartment syndrome caused by small bowel obstruction. The treatment of this case required surgical decompression of the abdomen which led to an instantaneous reperfusion of the left leg. Unfortunately, the patient deceased a few hours after the surgery due to haemodynamic deterioration.

Acute lower limb ischemia secondary to diffuse peritonitis

“…11 The patients with acute limb ischemia secondary to other underlying disease constitute a separate group. 8,12 In our case report, the patient presented with diffuse peritonitis being untimely diagnosed and complicated by acute arterial occlusion of the right lower limb. In case of severe endogenous intoxication, the cardiovascular system plays a critical role since the further course of the disease is determined by hemodynamic changes.…”

“…At the terminal stages, multiple organ failure is accompanied by coagulopathy and immune dysfunction that results in intravascular coagulation, immunocompromitation, and thrombosis. 7,8 Rapid recognition and treatment of acute lower limb ischemia in emergencies are critical to maximally reduce ischemia duration. Considering diverse causes of acute lower limb ischemia, clinical and diagnostic errors may result in a high price to the patient -amputation or even death.…”

Acute lower limb ischaemia secondary to aortic compression from uterine fibroid

“…One of the major causes of acute limb ischaemia is thrombosis in a pre-existing atherosclerotic arteries 3. Extrinsic compression onto the limb vessels resulting in acute limb ischaemia is a very rare phenomenon with only few reported cases in the literature 4–7…”