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Leriche syndrome

Article  in  International Journal of Emergency Medicine · October 2008

DOI: 10.1007/s12245-008-0039-x · Source: PubMed

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Wei-Jing Lee Yung-Ze Cheng

Chi-Mei Medical Center Chi-Mei Medical Center
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Int J Emerg Med (2008) 1:223
DOI 10.1007/s12245-008-0039-x

CLINICAL IMAGE

Leriche syndrome
Wei-Jing Lee & Yung-Ze Cheng & Hung-Jung Lin

Received: 18 January 2008 / Accepted: 20 May 2008 / Published online: 22 August 2008
# Springer-Verlag London Ltd 2008

A 45-year-old man with a past history of diabetes mellitus, Aortoiliac occlusive disease was first described in 1814
coronary artery disease with two-vessel disease, and by Robert Graham of London. Leriche syndrome was
peripheral arterial occlusive disease with gangrene of the named after René Leriche, a famous French surgeon who
left big toe, status post amputation, presented to the successfully operated “his” syndrome on a 29-year-old
emergency department. He was a heavy smoker and truck driver.
complained of severe distension, vomiting, and diffuse Traditional surgical treatments for aortoiliac occlusive
abdominal pain for 4–5 days. Computed tomography (CT) disease are aortoiliac endarterectomy (TEA) and aortobife-
was performed to determine if the pain and distension were moral bypass (AFB). For higher-risk patients, there are
caused by intestinal obstruction or ischemic bowel syn- alternative ways to avoid abdominal surgery such as
drome (Fig. 1). CT scan revealed aortoiliac occlusive axillofemoral bypass (extra-anatomic technique) and percu-
disease (Leriche syndrome). The patient underwent bilateral taneous transluminal angioplasty (PTA) and stenting.
axillofemoral bypass.
Leriche syndrome, also referred to as aortoiliac occlusive
disease, is due to thrombotic occlusion of the abdominal
aorta just above the site of its bifurcation.
The characteristic symptoms include inability to main-
tain penile erection, fatigue of both lower limbs, intermit-
tent bilateral claudication with ischemic pain, and absent or
diminished femoral pulses along with pallor or coldness of
both lower extremities.

W.-J. Lee : Y.-Z. Cheng (*) : H.-J. Lin

Department of Emergency Medicine, Chi-Mei Medical Center,
901 Chung-Hua Road, Fig. 1 Coronal reconstruction of contrast-enhanced CT scan of the
Yung-Kang City, Tainan 710, Taiwan abdomen revealed thrombosis from the distal abdominal aorta to the
e-mail: saab931103@yahoo.com.tw bilateral common femoral arteries

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