Acute lower limb ischaemia secondary to intestinal occlusion

BMJ Case Rep. 2018 Apr 7:2018:bcr2016218580. doi: 10.1136/bcr-2016-218580.

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.

Keywords: general surgery; vascular surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arterial Occlusive Diseases / diagnosis
  • Arterial Occlusive Diseases / etiology*
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / surgery
  • Critical Care
  • Enterostomy / adverse effects
  • Fatal Outcome
  • Hemodynamics
  • Humans
  • Iliac Artery / pathology*
  • Intestinal Obstruction / complications*
  • Intestinal Obstruction / diagnosis
  • Intestinal Obstruction / surgery
  • Intra-Abdominal Hypertension / surgery
  • Intraoperative Complications
  • Ischemia / diagnosis
  • Ischemia / etiology*
  • Ischemia / physiopathology
  • Ischemia / surgery
  • Lower Extremity / blood supply*
  • Male