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Difference between revisions of "Ditzels"
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→Leg amputation
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=Cardiovascular pathology= | =Cardiovascular pathology= | ||
==Leg amputation== | ==Leg amputation== | ||
=== | ===Overview=== | ||
Comes in two basic flavours: | Comes in two basic flavours: | ||
*Above the knee ampuation (AKA). | *Above the knee ampuation (AKA). | ||
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Etiology: | Etiology: | ||
*Diabetes mellitus - most common. | *Diabetes mellitus - most common - see ''[[atherosclerotic peripheral vascular disease]]''. | ||
*Trauma. | *Trauma. | ||
*Infection - see ''[[chronic osteomyelitis]]''. | |||
*Drug use, e.g. [[cocaine]].<ref name=pmid17059855/> | |||
==Atherosclerotic peripheral vascular disease== | |||
{{Main|Atherosclerosis}} | |||
===General=== | |||
*Very strong association with [[diabetes mellitus]]. | |||
===Gross=== | ===Gross=== | ||
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===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
* | *[[Atherosclerosis]]. | ||
** | *Coagulative [[necrosis]] (gangrene). | ||
* | *Inflammation (wet gangrene). | ||
**Neutrophils. | |||
**Lymphocytes. | |||
**Plasma cells. | |||
*+/-[[Thrombosis]]. | *+/-[[Thrombosis]]. | ||
*+/-[[Chronic osteomyelitis]]. | *+/-[[Chronic osteomyelitis]]. | ||
*+/-Reactive fibroblasts. | |||
Note: | Note: | ||
*Ischemia may be associated with marked nuclear changes. | *Ischemia may be associated with marked nuclear changes. Uninitiated eyes may think they are seeing a [[sarcoma]]. | ||
DDx: | |||
*[[Vasculitis]] associated with a [[connective tissue disorder]]. | |||
*Drug use, e.g. [[cocaine]].<ref name=pmid17059855>{{Cite journal | last1 = Dhawan | first1 = SS. | last2 = Wang | first2 = BW. | title = Four-extremity gangrene associated with crack cocaine abuse. | journal = Ann Emerg Med | volume = 49 | issue = 2 | pages = 186-9 | month = Feb | year = 2007 | doi = 10.1016/j.annemergmed.2006.08.001 | PMID = 17059855 }}</ref> | |||
===Sign out=== | ===Sign out=== | ||
<pre> | <pre> | ||
LEFT LEG, BELOW KNEE AMPUTATION: | LEFT LEG, BELOW KNEE AMPUTATION: | ||
- MODERATE-TO-SEVERE ATHEROSCLEROSIS. | |||
- COAGULATIVE NECROSIS OF SOFT TISSUE. | - COAGULATIVE NECROSIS OF SOFT TISSUE. | ||
- NECROTIC BONE. | - NECROTIC BONE. | ||
- MARROW CAVITY FIBROSIS WITH SIDEROPHAGES. | - MARROW CAVITY FIBROSIS WITH SIDEROPHAGES. | ||