Murali Uthamalingam, Ahmad Mohammad Azhar Anis, Najihah Fatin
Professor, Department of Surgery, IMS / Management and Science University, Shah Alam, Selangor, Malaysia.
Specialist, Department of Surgery, HTAR - Hospital, Shah Alam, Selangor, Malaysia.
J Clin Diagn Res. 2017 Mar;11(3):PD06-PD08. doi: 10.7860/JCDR/2017/23807.9507. Epub 2017 Mar 1.
Thromboangitis Obliterans (TAO) or Buerger's disease is a non-atherosclerotic, occlusive, progressive and highly inflammatory disorder of distal arteries seen predominantly affecting the lower limb in smokers. TAO presenting itself in upper limb or bilaterally involving the upper limb is a very rare entity. We report on a rare case of TAO in a 46-year-old gentleman who presented with bilateral upper extremity digital gangrene with 18 pack-years of smoking. Brachial and radial pulses were palpable bilaterally and were of good volume but right ulnar pulse was faintly felt, while on the left side it was not appreciated due to malunion. Further Computed Tomography (CT)- angiography showed occlusion of distal right ulnar artery, stenosis of distal left ulnar artery with bilateral poor opacification of palmar and digital arteries. This case reports on the unusual and rare presentation of TAO in upper extremity involving both limbs. The case is reported for the first time from Malaysia.
血栓闭塞性脉管炎（TAO）或伯格氏病是一种非动脉粥样硬化性、闭塞性、进行性且具有高度炎症性的远端动脉疾病，主要见于吸烟者的下肢。TAO出现在上肢或双侧累及上肢是一种非常罕见的情况。我们报告了一例罕见的TAO病例，患者为一名46岁男性，有18年的吸烟史，出现双侧上肢手指坏疽。双侧肱动脉和桡动脉均可触及，搏动良好，但右侧尺动脉搏动微弱，左侧因骨折畸形愈合未触及。进一步的计算机断层扫描（CT）血管造影显示右侧尺动脉远端闭塞,左侧尺动脉远端狭窄，双侧掌动脉和指动脉造影剂充盈不佳。本病例报告了TAO在上肢累及双肢的不寻常和罕见表现。该病例首次由马来西亚报道。
