Buerger's disease ( Thromboangiitis obliterans)

Buerger’s disease, also called thromboangiitis obliterans, is an inflammation of small- and medium-sized blood vessels. Although any artery can be affected, it usually presents with blockages of the arteries to the feet and hands, leading to pain and tissue damage.

The disease is found worldwide and can affect people of any race and age group. However, it mainly affects Asian and Middle Eastern men between the ages of 40 and 45 who heavily use, or have heavily used, tobacco products, including chewing tobacco.
There isn’t a cure for Buerger’s disease. However, the single-most important factor in improving symptoms and preventing its progression is quitting smoking.
In rare cases, the pain may be so severe that a surgical procedure called a sympathectomy may be performed to eliminate the pain.

2. BUERGER'S DISEASE
Presented by
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3. Definition
•Buerger'sdiseaseisatypeofvasculitisinwhichthere
isinflammationofthearteriesandveinsofthehandsor
feet.Buerger'sdiseasealsocalledthromboangiitis
obliterans.

4. THE CAUSE OF BUERGER'S DISEASE
•Smokingandtheuseofchewingtobacco.
•Itistheorizedthattobaccotriggersanautoimmune
reaction,inwhichthebody'simmunesystemmistakes
healthytissuesaspotentiallydangerousinvadesinto
thebodyandattacksthem.
•Thiscausesinflammationandthedevelopmentofclots
inthearteriesandveinsofthehandsandfeetthatare
characteristicofBuerger'sdisease.
•Buerger'sdiseaseoccursmostofteninyoungadultmen
whoareheavycigarettesmokers.

5. PATHOPHYSIOLOGY
•Healthyarteriesandveinsarecriticaltosupplyingvital
oxygenandnutrientstocellsandtissuesandremoving
wasteproducts.
•Thiscirculationiskeytothehealthofthecellsand
tissuesofthehandsandfeet.
•Buerger'sdiseaseinterfereswithcirculationleadingto
ischemiaofcellsandtissues.
•Inischemia,cellsareunabletoreproducenormally
recovereffectivelyfrominjury,andfightinfection.

6. SYMPTOMS OF BUERGER'S DISEASE
•Pain in the hands and feet and the development of
sores or lesions that do not heal.
•If Buerger'sdisease is left untreated, gangrene
(tissue death) can occur.
•Intermittent leg pains
•Leg numbness
•Leg tingling
•Leg burning
•Leg paresthesias

7. DIAGNOSIS
•Medicalhistory
•Tobaccousehistory
•Physicalexamination
•DiagnosisofBuerger'sdiseaseisbasedonmedicalhistory
andexaminationcombinedwithrulingoutavarietyof
otherdiseasesandconditions,suchasRaynaud's
phenomenonandothertypesofvasculitis.
•CBC
•Atestcalledanangiogrammaybeperformedtoassistin
diagnosisofBuerger'sdisease.
•Anangiogramisanimagingtestthatcreatesapictureofthe
arteriesandcanrevealthearterydamageandblockagesin
thehandsandfeetthataretypicalofBuerger'sdisease.

8. TREATMENT
•Buerger'sdiseasecanoftenbesuccessfullytreated
beforethedevelopmentofcomplications.
•Treatmentinvolvesquittingsmoking.
•Lowcholesteroldiet
•Lowsaltdiet
•Physicalexercise
•Controlweight
•Surgical- Sympathectomy [Transectionof
nerve,ganglion]

9. Complications
•Reviewpossiblemedicalcomplicationsrelatedto
Buerger'sdisease:
•Legbloodclots
•lockedlegarteries
•Fingerulcers
•Toeulcers
•Toegangrene
•Footgangrene

10. NURSING MANAGEMENT
•Assessing&monitoringanticoagulanttherapy
•Providingcomfort
•Applyingelasticcompressionstocking
•Positioningthebody&encouragingexercise
•IdentifyriskfactorspredisposingpatienttoDVT,
reevaluatestatusfrequently
•Implementorderedprophylacticregimen Non-
pharmacological&pharmacological
•Assessallofthepatientsextremitiesonaregularbasis
•Encourageearlyambulation&activelegexerciseevery
hourthepatientisawake.
•Monitorforlowgradefevertodetectthrombophlebitis
•Encouragefluidintake.
•Useofkneegatch(or)pillowsundertheknees.

11. NURSING DIAGNOSIS
•Acutepainrelatedtovenouscongestion,impaired
venousreturnandinflammation.
•Ineffectivehealthmaintenancerelatedtolackof
knowledgeaboutdisorderanditstreatment.
•Riskforimpairedskinintegrityrelatedtoperipheral
tissueperfusion.
•Riskforpotentialbleedingrelatedtoanticoagulant
therapy.