A case of Right great toe and 3rd toe gangrene.pptx

A case of Right great toe and 3rd toe gangrene

1. Mamta Chavan 17Y/F A case of Right great toe and 3rd toe gangrene

2. Clinical History Injury to right foot by stone 15 days back followed by blackish disocoration of great toe and 3rd toe

3. On Examination Right foot warm proximally and cold distally Right popliteal, DPA, PTA pulses absent Blackish discoloration on great toe and 3rd toe

4. Investigations ESR = 77 (Raised) CRP = 28.9 (Raised) CPK = 4.6 (Low) ANA = +++ (Speckled cytoplasmic granularity)

5. Radiological Investigations Doppler : Distal ischemia affecting PTA, DPA, ATA and small vessels of foot CT LL Angio: Complete non opacification of distal SFA and near complete non opacification of distal PTA

6. Procedure Right Common iliac and external iliac artery is normal in calibre and br anching pattern with normal course. There is abrupt cutoff in right distal superficial femoral artery for an a proximate length of 60 mm with distal reformation from collaterals. Rest of the superficial femoral artery appears normal. Right common femoral artery, profunda, and popliteal arteries are normal in course, calibre and branching pattern. ATA and peroneal arteries are normal in course, calibre and branching pattern PTA shows severe attenuation in its pacification throughout its course Plantar arch appears normal.