Thromboangiitis obliterans (TAO), also known as Buerger’s disease, is a rare condition causing inflammatory thrombosis Thrombosis Formation and development of a thrombus or blood clot in the blood vessel. Epidemic Typhus of the small- to medium-sized arteries and veins Arteries And Veins ACES and RUSH: Resuscitation Ultrasound Protocols of the upper and lower extremities. Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship are typically young smokers presenting with distal extremity ischemia Ischemia A hypoperfusion of the blood through an organ or tissue caused by a pathologic constriction or obstruction of its blood vessels, or an absence of blood circulation. Ischemic Cell Damage, ulcers, or gangrene Gangrene Death and putrefaction of tissue usually due to a loss of blood supply. Small Bowel Obstruction. Superficial thrombophlebitis and Raynaud's phenomenon can be early manifestations. Diagnosis is based on clinical findings, vascular testing, and angiography Angiography Radiography of blood vessels after injection of a contrast medium. Cardiac Surgery. Other potential diagnoses must be ruled out. The use of tobacco products is strongly associated with the disease; therefore, smoking Smoking Willful or deliberate act of inhaling and exhaling smoke from burning substances or agents held by hand. Interstitial Lung Diseases cessation is an essential part of management and decreases the risk of amputation Amputation An amputation is the separation of a portion of the limb or the entire limb from the body, along with the bone. Amputations are generally indicated for conditions that compromise the viability of the limb or promote the spread of a local process that could manifest systemically. Amputation.
Last updated: 10 Feb, 2021
Histopathologic specimen obtained from a patient with TAO. The vessel lumen has a thrombus rich in neutrophils Neutrophils Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. Innate Immunity: Phagocytes and Antigen Presentation (black star). Both the tunica intima Tunica intima The innermost layer of an artery or vein, made up of one layer of endothelial cells and supported by an internal elastic lamina. Arteries: Histology and media are normal (white and black arrows). Periarterial lymphocytic infiltrate is seen (white star).
Image: “Severe mesenteric infarction by superior mesenteric artery Superior mesenteric artery A large vessel supplying the whole length of the small intestine except the superior part of the duodenum. It also supplies the cecum and the ascending part of the colon and about half the transverse part of the colon. It arises from the anterior surface of the aorta below the celiac artery at the level of the first lumbar vertebra. Small Intestine: Anatomy occlusion in a patient suffering from Buerger’s disease” by Ratbi MI MI MI is ischemia and death of an area of myocardial tissue due to insufficient blood flow and oxygenation, usually from thrombus formation on a ruptured atherosclerotic plaque in the epicardial arteries. Clinical presentation is most commonly with chest pain, but women and patients with diabetes may have atypical symptoms. Myocardial Infarction, Abissegue GY, Tarchouli M, Tajedine MT. License: CC BY 2.0.The inflammatory thrombus occluding arteries and veins Arteries And Veins ACES and RUSH: Resuscitation Ultrasound Protocols of the distal extremities leads to diminished blood supply, causing damage and tissue death distally.
Image by Lecturio.Superficial thrombophlebitis of the right leg Leg The lower leg, or just “leg” in anatomical terms, is the part of the lower limb between the knee and the ankle joint. The bony structure is composed of the tibia and fibula bones, and the muscles of the leg are grouped into the anterior, lateral, and posterior compartments by extensions of fascia. Leg: Anatomy. Notice the arrow pointing at a darkened cord-like structure that is following venous distribution. The cord-like structures are tender and can be the initial presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor of TAO.
Image: “Ischemic toes after venous thromboembolism Thromboembolism Obstruction of a blood vessel (embolism) by a blood clot (thrombus) in the blood stream. Systemic Lupus Erythematosus: a difficult differential diagnosis with good response to combination therapy-a case report” by Owlia MB, Salimzadeh A, Alishiri G, Kargar S. License: CC BY 3.0.Ischemic ulceration Ulceration Corneal Abrasions, Erosion, and Ulcers and necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage of the middle finger of the left hand Hand The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves. Hand: Anatomy in a patient with TAO. Inflammatory thrombus in distal arteries and veins Arteries And Veins ACES and RUSH: Resuscitation Ultrasound Protocols causes digital ischemia Ischemia A hypoperfusion of the blood through an organ or tissue caused by a pathologic constriction or obstruction of its blood vessels, or an absence of blood circulation. Ischemic Cell Damage, ulceration Ulceration Corneal Abrasions, Erosion, and Ulcers, and necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage.
Image: “Raynaud’s Phenomenon” by Shah J, Billington AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation, Elston JB, Payne WG. License: CC BY 2.0.The diagnosis can be established without biopsy Biopsy Removal and pathologic examination of specimens from the living body. Ewing Sarcoma if the following criteria are met MET Preoperative Care:
Abdominal aorta Abdominal Aorta The aorta from the diaphragm to the bifurcation into the right and left common iliac arteries. Posterior Abdominal Wall: Anatomy CT angiography Angiography Radiography of blood vessels after injection of a contrast medium. Cardiac Surgery of a patient with TAO showing total occlusion of both renal arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries: Histology (white arrows)
Image: “Contrast-enhanced abdominal CT and abdominal aorta Abdominal Aorta The aorta from the diaphragm to the bifurcation into the right and left common iliac arteries. Posterior Abdominal Wall: Anatomy CT angiography Angiography Radiography of blood vessels after injection of a contrast medium. Cardiac Surgery” by Yun et al AL Amyloidosis. 2015. License: CC BY 4.0, edited by Lecturio.