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Difference between revisions of "Vascular disease"
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→Thromboangiitis obliterans
(→Thromboangiitis obliterans: tweak) |
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===General=== | ===General=== | ||
*Strong association with smoking.<ref>{{Cite journal | last1 = Highlander | first1 = P. | last2 = Southerland | first2 = CC. | last3 = VonHerbulis | first3 = E. | last4 = Gonzalez | first4 = A. | title = Buerger disease (thromboangiitis obliterans): a clinical diagnosis. | journal = Adv Skin Wound Care | volume = 24 | issue = 1 | pages = 15-7 | month = Jan | year = 2011 | doi = 10.1097/01.ASW.0000392923.37852.43 | PMID = 21173586 }}</ref> | *Strong association with smoking.<ref>{{Cite journal | last1 = Highlander | first1 = P. | last2 = Southerland | first2 = CC. | last3 = VonHerbulis | first3 = E. | last4 = Gonzalez | first4 = A. | title = Buerger disease (thromboangiitis obliterans): a clinical diagnosis. | journal = Adv Skin Wound Care | volume = 24 | issue = 1 | pages = 15-7 | month = Jan | year = 2011 | doi = 10.1097/01.ASW.0000392923.37852.43 | PMID = 21173586 }}</ref> | ||
* | *Clinical-radiologic diagnosis.<ref name=pmid20534945/> | ||
Typical symptoms/signs - progression:<ref name=pmid22284771/> | Typical symptoms/signs - progression:<ref name=pmid22284771/> | ||
*Intermittent claudication -> ulcers -> [[gangrene]] | *Intermittent claudication -> ulcers -> [[gangrene]] -> [[amputation]]. | ||
Treatment: | Treatment: | ||
*Stop smoking.<ref name=pmid22284771>{{Cite journal | last1 = Dargon | first1 = PT. | last2 = Landry | first2 = GJ. | title = Buerger's disease. | journal = Ann Vasc Surg | volume = 26 | issue = 6 | pages = 871-80 | month = Aug | year = 2012 | doi = 10.1016/j.avsg.2011.11.005 | PMID = 22284771 }}</ref> | *Stop smoking.<ref name=pmid22284771>{{Cite journal | last1 = Dargon | first1 = PT. | last2 = Landry | first2 = GJ. | title = Buerger's disease. | journal = Ann Vasc Surg | volume = 26 | issue = 6 | pages = 871-80 | month = Aug | year = 2012 | doi = 10.1016/j.avsg.2011.11.005 | PMID = 22284771 }}</ref> | ||
===Gross=== | |||
*Afflicts small and medium-sized vessels of the extremities. | |||
*Corkscrew vessels - seen on angiography.<ref name=pmid20534945>{{Cite journal | last1 = Fujii | first1 = Y. | last2 = Soga | first2 = J. | last3 = Nakamura | first3 = S. | last4 = Hidaka | first4 = T. | last5 = Hata | first5 = T. | last6 = Idei | first6 = N. | last7 = Fujimura | first7 = N. | last8 = Nishioka | first8 = K. | last9 = Chayama | first9 = K. | title = Classification of corkscrew collaterals in thromboangiitis obliterans (Buerger's disease): relationship between corkscrew type and prevalence of ischemic ulcers. | journal = Circ J | volume = 74 | issue = 8 | pages = 1684-8 | month = Aug | year = 2010 | doi = | PMID = 20534945 }}</ref> | |||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=pmid16892557>{{Cite journal | last1 = Kurata | first1 = A. | last2 = Schulz | first2 = A. | last3 = Franke | first3 = FE. | title = Reappraisal of thromboangiitis obliterans--a pathological contribution. | journal = Verh Dtsch Ges Pathol | volume = 88 | issue = | pages = 231-6 | month = | year = 2004 | doi = | PMID = 16892557 }}</ref> | Features:<ref name=pmid16892557>{{Cite journal | last1 = Kurata | first1 = A. | last2 = Schulz | first2 = A. | last3 = Franke | first3 = FE. | title = Reappraisal of thromboangiitis obliterans--a pathological contribution. | journal = Verh Dtsch Ges Pathol | volume = 88 | issue = | pages = 231-6 | month = | year = 2004 | doi = | PMID = 16892557 }}</ref> | ||
*Acute inflammation: | *Acute inflammation: | ||
** Endarteritis - | ** Endarteritis - neutrophils at the internal elastic lamina (IEL). | ||
** Periarteritis. | ** Periarteritis - neutrophils around the arteries. | ||
** Typically segmental.<ref name=pmid22284771/> | *Obliteration of the lumen - intimal thickening. | ||
Notes: | |||
* Typically segmental.<ref name=pmid22284771/> | |||
DDx: | |||
*[[Peripheral vascular disease]] ([[atherosclerosis]]) - typically lacks the acute inflammation around the IEL and around the vessels. | |||
*[[Vasculitis]] - have [[fibrinoid necrosis]]. | |||
===Sign out=== | |||
<pre> | |||
MIDDLE FINGER DISTAL PHALYNX, LEFT, AMPUTATION: | |||
- GANGRENE WITH ENDARTERITIS, PERIARTERITIS AND LUMINAL OBLITERATION/NARROWING | |||
CONSISTENT WITH THROMOANGITIS OBLITERANS (BUERGER'S DISEASE). | |||
</pre> | |||
==Thrombosis== | ==Thrombosis== | ||