Martinet O, Vuilleumier H, Fournier D, Jayet A, Genton A, Chapuis G
Service de chirurgie générale, CHUV, Lausanne.
Swiss Surg. 1995(6):311-3.
Ergot's derivatives are widely used in the treatment of migraine and in the prophylaxy of deep venous thrombosis in association with heparin. Clinical ergotism is rarely observed and can affect all the arteries, especially of the inferior limbs. Vasospasm of the peripheral arteries and collateral formation are specific findings on angiography. We report the illustrative case of a 38 years old woman hospitalized for a small bowel occlusion. She suffers from chronic migraine treated by ergotamine tartrate. During her hospitalization, she develops an acute ischemia of the lower limbs. An ergotism was clinically suspected and confirmed by Duplex sonography which demonstrate multiple vasospasm. Under iv sodium nitroprusside and peridural analgesia the spasm resolved in 24 hours. The control Duplex sonography confirm the normality of the lower limb arteries. This examination modality allow a non-invasive diagnosis and evolution control of arteriospasm.
麦角衍生物广泛用于偏头痛的治疗以及与肝素联合用于深部静脉血栓形成的预防。临床麦角中毒很少见,可累及所有动脉,尤其是下肢动脉。外周动脉血管痉挛和侧支形成是血管造影的特异性表现。我们报告了一名38岁因小肠梗阻住院的女性的典型病例。她患有慢性偏头痛,用酒石酸麦角胺治疗。住院期间,她出现了下肢急性缺血。临床上怀疑为麦角中毒,并通过双功超声检查得以证实,该检查显示多处血管痉挛。在静脉注射硝普钠和硬膜外镇痛治疗下,痉挛在24小时内缓解。双功超声复查证实下肢动脉正常。这种检查方式可对动脉痉挛进行无创诊断和病情监测。