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Ann Vasc Surg. 2018 Aug;51:327.e1-327.e8. doi: 10.1016/j.avsg.2018.02.012. Epub 2018 Apr 13.

Acute Limb Ischemia in an 8-Year-Old Patient: A Case Report.

Author information

1
Section of Vascular and Endovascular Surgery, Yale University School of Medicine, New Haven, CT. Electronic address: young.erben@yale.edu.
2
Warren Alpert Medical School at Brown University, Providence, RI.
3
Section of Vascular and Endovascular Surgery, Yale University School of Medicine, New Haven, CT.
4
Section of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT.
5
Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
6
Department of Orthopedic Surgery and Anesthesia, Yale University School of Medicine, New Haven, CT; Department of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT.
7
Department of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT.

Abstract

We report the case of an 8-year-old patient with a history of nephrotic syndrome, who presented to the emergency department with right foot pain. The patient's mother described intermittent pain that woke her son from sleep and was accompanied by the foot turning purple and becoming cold to touch. Physical examination revealed capillary refill of over 10 seconds in the right and less than 2 seconds in the left foot. Ankle-brachial indices (ABIs) were 0.0 on the right and 0.96 on the left. The patient was admitted and started on therapeutic intravenous heparin. After consultation with his parents, right lower extremity angiography and thrombolysis was performed over 2 days. He subsequently underwent fasciotomy and amputation of the tip of all 5 toes. Eighteen months later, there is no leg length discrepancy, he is walking with foot inserts and has normal ABIs bilaterally.

PMID:
29655809
DOI:
10.1016/j.avsg.2018.02.012
[Indexed for MEDLINE]

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