Page 76 - Virtual Vascular Vol 4
P. 76

Gangrene                                                                                                                                                                                          Renal aneurysm

































































                                                                                                                                    62 year old lady with an incidental finding of a
                                                                                                                                A  small (1cm diameter) right renal artery saccular
                                                                                                                                aneurysm near the hilum.  These are increasingly
                                                                                                                                detected due to liberal use of CT scan in medical prac-

                                                                                                                                tice.  If asymptomatic the threshold of intervention is
                                                                                                                                2cm (or larger), and smaller aneurysms can be safely
                                                                                                                                observed.  First line treatment is generally coil emboli-
                                                                                                                                zation.
             rather shocking photo of the gangrenous foot of an institutionalized patient.  She
        A is bedridden with multiple contractures and developed dry gengrene of her foot

        which had progressed due to lack of care.  The family refused amputation.  Eventually
        infection and pneumonia will prove fatal.

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