Case Report
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Jinekolojik onkoloji cerrahi sonrası eyer(saddle) embolisi düşündüren akut bilateral alt ekstremite iskemisi: Olgu Sunumu

Year 2020, Volume: 27 Issue: 1, 119 - 122, 01.03.2020
https://doi.org/10.17343/sdutfd.442902

Abstract

    Akut alt ekstremite iskemilerinin en sık nedeni ateroembolilerdir ve
bunların orjini çok yüksek oranla kardiyaktır. 
Non-kardiak nedenler arasında; ateromatöz emboli, arteryal anevrizmlar,
tümörler, travmalar yabancı cisime bağlı ve iatrojenik nedenler sayılabilir. 
Nadir de olsa aorta-iliak okluviz hastalık(Leriche Sendromu) daha proksimalden
kaynaklanan embolizasyon sonucu akut bilateral alt ekstremite iskemisi ile
karşımıza gelebilir.

    50 yaşında bayan hasta daha önceden bilinen hastalağı yok endometrium
kanseri nedeniyle jinekolojik onkoloji cerrahisi(total histerektomi, radikal lenf nodu diseksiyonu, omentektomi sonrasında p
ostopertatif 24. saatte bilateral alt ekstremite iskemisi gelişmesi nedeniyle acil opere edildi. Femoral embolektomi sonrası batın açılarak her iki iliak femoral artere yapay greft ile bypass yapıldı. Hasta medikal ve fizik tedavi sonrası şifa ile taburcu edildi.

    Abdominal ve retroperitonal malignite cerrahisinde inferior mesenterik
arterin bağlanması gereken durumlarda ayrıntılı anamnez ve fizik muayenenin
önemi büyüktür. Cerrahi öncesi kontrastlı BT anjiyonun çekilmesi ve ayrıntılı
incelenmesinin, damar invazyonunu göstermesi açısından ve İMA nın bağlanması
gereken durumlarda hayat kurtarıcı olabileceği kanaatindeyiz.



References

  • 1 Bozkurt K, ve ark. (2007) Türk Kalp Damar Cerrahisi Derneği Periferik Arter ve Ven Hastalıkları Tedavi Kılavuzu. 1. Taslak.
  • 2 Furrer M, Schüler M, Leutenegger AF, Rüedi T. (1994)Acute Leriche syndrome in a previously healthy woman: differential diagnosis of embolic occlusion Helv Chir Acta. Dec;60(6):887-91
  • 3 Lee WJ, Cheng YZ, Lin HJ. (2008) Leriche’s syndrome. Int J Emerg Med;1:223.
  • 4 Kakkos SK, Shepard AD. (2008) Delayed presentation of aortic injury by pedicle screws: report of two cases and review of the literature. J Vasc Surg;47:1074-82.
  • 5 Leriche R, Morel A. (1948) The syndrome of thrombotic obliteration of the aortic bifurcation. Ann Surg ; 127: 193–206.
  • 6 G. Bruce Hopkins, MD (1968) Leriche Syndrome Associated With Leiomyosarcoma of the Right Common Iliac Artery AMA.;206(8):1789-1790
  • 7 Frederick M, Newman J, Kohlwes K, et al. (2010) Leriche syndrome. J Gen Intern Med ; 25(10): 1102–1104.
  • 8 Lee WA. (2003) Acute aortic occlusion from a cardiac embolus. J Vasc Surg;38:197.
  • 9 Babu SC, Shah PM, Nitahara J. (1995) Acute aortic occlusionfactors that influence outcome. J Vasc Surg;21:567-72.
  • 10 Liggett C, Kartchner M: (1979) Peripheral arterial tumor embolism by malignant tumor. West J Med 130:72-75,
  • 11 Zerbino DD, Lukasevich LL, Servetnik MI. (1994) Thrombosis and embolism as paraneoplastic syndrome Arkh Patol. Jul-Aug;56(4):77-80.
  • 12 Singh D et all (2017) The long-term survival benefits of high and low ligation of inferior mesenteric artery in colorectal cancer surgery: A review and meta-analysis Medicine (Baltimore). Nov;96(47):e8520
  • 13 Thomas Sandgren, MD, Björn Sonesson, MD ve ark (1999).The diameter of the common femoral artery in healthy human: Influence of sex, age, and body size J Vasc Surg. Mar;29(3):503-10.
  • 14 Jin Hyun Joh, Hyung-Joon Ahn, and Ho-Chul Park (2013) Reference Diameters of the Abdominal Aorta and Iliac Arteries in the Korean Population Yonsei Med J. Jan 1; 54(1): 48–54.
  • 15 Mahmoud Assaad, Sunit Tolia, and Marcel Zughaib (2017) Leriche syndrome: The inferior mesenteric artery saves the lower extremity Open Med Case Rep.; 5:
  • 16 Howard A. Liebman and Ilene C. Weitz (2014) Rutherford's Vascular Surgery, 2-Volume Set, 8th Edition Chapter 37 Hypercoagulable states
Year 2020, Volume: 27 Issue: 1, 119 - 122, 01.03.2020
https://doi.org/10.17343/sdutfd.442902

Abstract

References

  • 1 Bozkurt K, ve ark. (2007) Türk Kalp Damar Cerrahisi Derneği Periferik Arter ve Ven Hastalıkları Tedavi Kılavuzu. 1. Taslak.
  • 2 Furrer M, Schüler M, Leutenegger AF, Rüedi T. (1994)Acute Leriche syndrome in a previously healthy woman: differential diagnosis of embolic occlusion Helv Chir Acta. Dec;60(6):887-91
  • 3 Lee WJ, Cheng YZ, Lin HJ. (2008) Leriche’s syndrome. Int J Emerg Med;1:223.
  • 4 Kakkos SK, Shepard AD. (2008) Delayed presentation of aortic injury by pedicle screws: report of two cases and review of the literature. J Vasc Surg;47:1074-82.
  • 5 Leriche R, Morel A. (1948) The syndrome of thrombotic obliteration of the aortic bifurcation. Ann Surg ; 127: 193–206.
  • 6 G. Bruce Hopkins, MD (1968) Leriche Syndrome Associated With Leiomyosarcoma of the Right Common Iliac Artery AMA.;206(8):1789-1790
  • 7 Frederick M, Newman J, Kohlwes K, et al. (2010) Leriche syndrome. J Gen Intern Med ; 25(10): 1102–1104.
  • 8 Lee WA. (2003) Acute aortic occlusion from a cardiac embolus. J Vasc Surg;38:197.
  • 9 Babu SC, Shah PM, Nitahara J. (1995) Acute aortic occlusionfactors that influence outcome. J Vasc Surg;21:567-72.
  • 10 Liggett C, Kartchner M: (1979) Peripheral arterial tumor embolism by malignant tumor. West J Med 130:72-75,
  • 11 Zerbino DD, Lukasevich LL, Servetnik MI. (1994) Thrombosis and embolism as paraneoplastic syndrome Arkh Patol. Jul-Aug;56(4):77-80.
  • 12 Singh D et all (2017) The long-term survival benefits of high and low ligation of inferior mesenteric artery in colorectal cancer surgery: A review and meta-analysis Medicine (Baltimore). Nov;96(47):e8520
  • 13 Thomas Sandgren, MD, Björn Sonesson, MD ve ark (1999).The diameter of the common femoral artery in healthy human: Influence of sex, age, and body size J Vasc Surg. Mar;29(3):503-10.
  • 14 Jin Hyun Joh, Hyung-Joon Ahn, and Ho-Chul Park (2013) Reference Diameters of the Abdominal Aorta and Iliac Arteries in the Korean Population Yonsei Med J. Jan 1; 54(1): 48–54.
  • 15 Mahmoud Assaad, Sunit Tolia, and Marcel Zughaib (2017) Leriche syndrome: The inferior mesenteric artery saves the lower extremity Open Med Case Rep.; 5:
  • 16 Howard A. Liebman and Ilene C. Weitz (2014) Rutherford's Vascular Surgery, 2-Volume Set, 8th Edition Chapter 37 Hypercoagulable states
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Case Reports
Authors

Kadir Burhan Karadem

Ahmet Rıfkı Çora

Publication Date March 1, 2020
Submission Date July 12, 2018
Acceptance Date August 27, 2018
Published in Issue Year 2020 Volume: 27 Issue: 1

Cite

Vancouver Karadem KB, Çora AR. Jinekolojik onkoloji cerrahi sonrası eyer(saddle) embolisi düşündüren akut bilateral alt ekstremite iskemisi: Olgu Sunumu. Med J SDU. 2020;27(1):119-22.

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