Cerbu Simona, Bîrsăşteanu Florin, Heredea Elena Rodica, Iacob Daniela, Iacob Emil Radu, Stănciulescu Maria Corina, Boia Eugen Sorin
Department of Pediatric Surgery, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania;
Rom J Morphol Embryol. 2018;59(4):1041-1044.
The acute limb ischemia (ALI) in neonates is a rare phenomenon, but with serious consequences if undiagnosed or untreated. The purpose of this review is to briefly present the etiology of ALI and morphological findings in correlation with specific causes. Etiology can be classified into two main groups: prenatal (in utero compression, thrombosis and embolism) and postnatal (iatrogenic, thromboembolism and vascular malformations). The most common cause of ALI is catheter-related thrombosis (almost 90% of thrombosis cases are associated with catheter use), but other rare causes like vascular malformations should not be overlooked. Ultrasound represents a non-invasive, inexpensive and widely available imaging technique, which provides sufficient information to evaluate the situation and establish proper therapeutic strategies. Morphological tests do not represent the standard diagnostic procedure in ALI, but they can provide useful information. The findings depend on the etiology: intraluminal thrombi, vascular changes, placental pathological modifications. Every morphological result must be correlated with the clinical picture and imagistic findings. In conclusion, ALI in neonates is a rare condition, usually associated with catheter use in intensive care unit setting, with multiple risk factors and conditions that increase the risk of occurrence.
新生儿急性肢体缺血（ALI）是一种罕见现象，但如果未被诊断或治疗，后果严重。本综述的目的是简要介绍ALI的病因以及与特定病因相关的形态学表现。病因可分为两大类：产前（子宫内压迫、血栓形成和栓塞）和产后（医源性、血栓栓塞和血管畸形）。ALI最常见的病因是导管相关血栓形成（几乎90%的血栓形成病例与使用导管有关），但其他罕见病因如血管畸形也不应被忽视。超声是一种无创、廉价且广泛可用的成像技术，它能提供足够的信息来评估病情并制定合适的治疗策略。形态学检查并非ALI的标准诊断程序，但能提供有用信息。检查结果取决于病因：管腔内血栓、血管变化、胎盘病理改变。每项形态学结果都必须与临床表现和影像学检查结果相关联。总之，新生儿ALI是一种罕见病症，通常与重症监护病房使用导管有关，存在多种增加发病风险的危险因素和情况。
