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Acute bilateral arterial occlusion in a young woman with no source of embolus
(Portuguese PDF version)

Coordinated by Dr. João Luiz Sandri
João Luiz Sandri¹, Giuliano de Almeida Sandri²

1. Assistant Professor of Clinical Surgery, Department of Surgery, School of Medicine, Santa Casa de Misericórdia de Vitória.
2. Medical Student, Universidade Federal do Espírito Santo.

Correspondence:
Dr. João Luiz Sandri
Av. Nossa Senhora da Penha, 714, Conj 1006-8
CEP 29055-130 - Vitória - ES
E-mail: jlsandri@escelsa.com.br

J Vasc Br 2003;2(1):33-34

Part I - CASE REPORT

A 40-year-old woman, admitted to the emergency room, presented with pain and intense burning sensation on the lower limbs, tingling on toetips for 48 hours. On physical examination, she presented with bilateral cyanosis of the feet and legs, combined with pale areas, lower temperature on both extremities, and absence of popliteal, posterior tibial and pedal pulses.

Acute bilateral ischemia, with simultaneous onset, was present. No past history of smoking, heart disease or intermittent claudication was reported. Bilateral arteriography of the femur was performed to elucidate the diagnosis. The patient was submitted to epidural anesthesia for pain relief and increased comfort during the exam. The first x-rays revealed diffuse arterial spasms.

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Click here for the answer of the diagnostic challenge.