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Foot of an 80-year old individual with type 2 diabetes and heart failure. The second toe has a large ischaemic ulcer. The first toe has a small one. The prevalence of arterial insufficiency ulcers among people with Diabetes is high due to decreased blood flow caused by the thinning of arteries and the lack of sensation due to diabetic neuropathy.
Martorell's ulcer, also known as hypertensive leg ulcer or necrotic angiodermatitis, [1] is a painful ulceration of the lower leg associated with diastolic [citation needed] arterial hypertension. It was first identified by the Spanish cardiologist Fernando Martorell in 1945, [ 3 ] [ 4 ] who referred to the ulcers as 'hypertensive ischaemic ...
Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
A venous ulcer tends to occur on the medial side of the leg, typically around the medial malleolus in the 'gaiter area' whereas arterial ulcer tends to occur on lateral side of the leg and over bony prominences. A venous ulcer is typically shallow with irregular sloping edges whereas an arterial ulcer can be deep and has a 'punched out' appearance.
In one report 10% of 100 people investigated for iron deficiency anemia had a large hiatal hernia. [3] A 1967 review found that 20% of 1305 individuals having surgery for hiatal hernia were anemic. [4] Cameron in 1976 [5] compared 259 people with large hiatal hernias visible on chest x-ray with 259 controls without hernias. Present or past ...
Pressure ulcers can trigger other ailments, cause considerable suffering, and can be expensive to treat. Some complications include autonomic dysreflexia, bladder distension, bone infection, pyarthrosis, sepsis, amyloidosis, anemia, urethral fistula, gangrene and very rarely malignant transformation (Marjolin's ulcer – secondary carcinomas in chronic wounds).
Classically, there is a solitary ulcer. But only 20% of patients have a single ulcer whereas in other cases there may be multiple lesions. [6] The size of the ulcers is usually 0.5–4 cm. [5] The lesion is most often located on the anterior (front) or lateral (side) rectal wall, centered on a rectal fold, [1] usually 10 cm from the anal verge. [8]
Acute intestinal ischemia affects about five per hundred thousand people per year in the developed world. [4] Chronic intestinal ischemia affects about one per hundred thousand people. [5] Most people affected are over 60 years old. [3] Rates are about equal in males and females of the same age. [3] Intestinal ischemia was first described in ...