Unsymmetrical swelling of the legs

Hello! At my mum, age of 85 years, about one month ago there were edemas on legs or foots. There is more swelling on the right leg. There is pain. 3 months ago she had an intestinal infarction, treated with anticoagulants, droppers. After discharge, anticoagulants were not prescribed. She herself from the blood-throaling preparations takes a cardiomagnet, and about 2 weeks ago she started the quarantil in the lowest dosage. What is the probability that this is a thrombus? What advise to do, she almost can not walk. Do I have to insist on hospitalization? Or it is possible to prescribe a treatment at home without diagnosis (given the impossibility of examining outpatiently).

Presumably, there is one of the permanent forms of rhythm disturbance. The risk of thrombosis and thromboembolism is high. Self-medication is unacceptable. Indications for stats. treatment is absolute. The main specialist is an angiosurgeon.

What is the probability that this is a thrombus?
If the cause of asymmetric edema of the lowerlimb was a venous thrombosis, by the present moment (a month has passed) a thrombus, most likely, is densely fixed to the venous wall, hence, its detachment is unlikely. Nevertheless, you should still perform duplex scanning of the deep veins (since variants with a poorly fixed thrombus and "refreshment" of thrombosis are possible).
Asymmetric swelling is not necessarily a thrombosis. Other common causes: varicose veins (without thrombosis), lymphatic insufficiency. The tactics of treatment can be different, so a specialist's examination is very important.
What advise to do, she almost can not walk.
It is not clear that she can not walk in connection withacute disease, accompanied by asymmetric edema, or due to long-term pathology (often joint or neurological).
Indications for stats. treatment is absolute. The main specialist is an angiosurgeon.
I can not state this with such confidence. Absolute indications for inpatient treatment in this situation are not clear to me. confused:

By the way, 3 months ago she had an intestinal infarction, treated with anticoagulants, droppers.
Her operated on? If not, how was the intestinal infarction diagnosed?

For a thrombosis of the lower limb says anamnesis, swelling. Against the absence of pain syndrome. It should be more pronounced. Not described. Edema is present on the second limb. It is not clear whether swelling subsides or persistent. Whether ripple is saved. Not enough information. Given the age of the patient, the presence of cardiovascular failure hospitalization in the department of vascular surgery.

Thank you very much for your answers. There was a local therapist, she noticed the reddened thumb and redness of her leg. Edema assessed as small. Has given a direction in a hospital. Unfortunately, I'm not sure if there is a specialist angio-surgeon in the regional center.

dav1972 "It's unclear, she can not walk due toacute disease, accompanied by asymmetric edema, or due to a long-term pathology (often joint or neurological). "

Along with the long-existing pathology (impaired coordination due to ataxia, also, 5 years ago there was a stroke), she notes a sharp deterioration in the last 10 days, "heavy" legs.


Quote:
dav1972 "how was the diagnosis of myocardial infarction diagnosed?"


The diagnosis of "intestinal infarction" was diagnosed after laparotomy.


Quote:
dav1972 "should still perform duplex scanning of deep veins (since variants with a poorly fixed thrombus and" refreshment "of thrombosis are possible)."


I hope the city hospital is equipped with this equipment. I'm not sure that on Saturday-Sunday she will be scanned. Whether tomorrow they will be hospitalized with the current direction is also not sure.

I read somewhere in the network such an opinion: "while thrombosis is not excluded, one should treat the disputed situation as a thrombosis."

I would be very grateful for further comments.

For a thrombosis of the lower limb says anamnesis, swelling. Against the absence of pain syndrome. It should be more pronounced. Not described. Edema is present on the second limb. It is not clear whether swelling subsides or persistent. Whether ripple is saved. Not enough information. Given the age of the patient, the presence of cardiovascular failure hospitalization in the department of vascular surgery.

The last 6 days the swelling on the right leg does not fall off. Before that, swelling subsided by morning, but there was more edema on the right leg. Pain is when the right foot moves to the floor and palpation. There is no pain on my left leg. Explain, please, about the pulsation, can you determine yourself.

While the tromoza is not excluded it is better to be stitched. A reddened finger can speak of a circulatory disturbance. I wonder whether the pulsation is preserved. Of course in the regional clinic there must be a vascular surgeon and the corresponding equipment. You can try to call an ambulance to show directions and be hospitalized in an emergency.

While the tromoza is not excluded it is better to be stitched. A reddened finger can speak of a circulatory disturbance. I wonder whether the pulsation is preserved. Of course in the regional clinic there must be a vascular surgeon and the corresponding equipment. You can try to call an ambulance to show directions and be hospitalized in an emergency.

Yes, she plans so. Tomorrow morning.


From under the nail on the finger does not stand pus?
Presumably, my mother does not have diabetes?

There is no pus, doctors deny diabetes mellitus.

I hope she continues to take a cardiomatograph.
Do sharp pains occur, touching the joint? ("thumb")

No, there is no pain when touching. She replaced the cardiomagnet with a 2-fold intake of quarantil at 0.25 per day. Or continue both?

Most likely it is a obliterating disease of the vessels of the lower extremities

Hospitalization, however, is necessary?

Presumably, there is one of the permanent forms of rhythm disturbance. The risk of thrombosis and thromboembolism is high. Self-medication is unacceptable. Indications for stats. treatment is absolute. The main specialist is an angiosurgeon.


DIAMAL, from your answer follows that violationrhythm is the cause of thrombosis and thromboembolism, or did I misunderstand? Why did you assume that there is a rhythm disturbance? Fighting rhythm disturbances is a pacemaker? Or something else?

In general, I "vote" for hospitalization. In the morning - the deadline.

When entering the hospital on Saturday morning is unlikely to be any serious diagnosis. Till Monday. Or is it not? Assign a dropper with anticoagulants, do you think?

A lot of different diagnoses have been written - from arrhythmia with thromboembolism to obliterating arterial lesions, although in practice it is first of all necessary to exclude venous thrombosis.
Despite the fact that the potential thrombosislong enough - about a month, if not more, and the idea had already recorded a blood clot in the vein wall, but anticoagulant therapy for the illness was not carried out, so nothing prevented thrombus grow. So emergency consultation of the vascular surgeon is shown.

Dear (a) Susanin Venous thrombosisis present but it is not an independent disease, but only a complication of the underlying, often combined with arrhythmias, they also contribute to the formation of blood clots. There is heart failure, as well as atherosclerosis (obliterans for-I). chronic venous insufficiency and there may be insufficiency over a large range of circulatory system. This complex problem. Therefore, it was a question of so many diagnoses.

The condition after stroke significantly improved from Cavinton. You do not allow an individual reaction Stroke is a disease in which an improvement can occur regardless of the treatment.
Improvement after taking Cavinton does not mean improvement due to its use. There is no reason to believe that Cavinton accelerates recovery after a stroke.

[QUOTE = michmed; 384385] Could you please lay out the last hospitalization? [/ QU

I have not used a scanner for a long time, it seemsis adapted to my current version of Windows. I'll figure it out how. Maybe something specific interests you, what can I reprint? There are a lot of mistakes in the extract. For example, it is not indicated that they were treated with anticoagulants. (!) The statement was made by a very young doctor (maybe a student?), Which appeared on the last days of hospitalization. I then called the office about this statement. There are a lot of obvious absurdities, the date of laparotomy is mixed up (it is indicated FOR THE DAY before discharge.)

Sorry, I did not understand in one of your reports you were talking about conservative treatment of myocardial infarction (thrombosis of the mesenteric vessels of the intestine?) Now you write about laporotomy. Was there an operation?

Sorry, I did not understand in one of your reports you were talking about conservative treatment of myocardial infarction (thrombosis of the mesenteric vessels of the intestine?) Now you write about laporotomy. Was there an operation?


Detail about bowel infarction. A sharp pain in the abdomen began on Thursday, (3 months ago) at the same time fell into a hospital (therapy), vomiting with bile joined. On Monday, he was transferred to surgery, put the above diagnosis, began conservative treatment. On Monday evening, urgent surgery for life. Drainage is done, there is nothing to remove, since too much is struck. The forecast is poor, the chances are 5%. Conservative therapy was continued. At once I will say that the average doctor does not believe in this story. But since there are special experts here, they will confirm that this happens.

Stroke is a disease in which improvement can occur regardless of treatment.
Improvement after taking Cavinton does not mean improvement due to its use. There is no reason to believe that Cavinton accelerates recovery after a stroke.

Well, I do not know. Maybe it was not a stroke? But the diagnosis was a stroke. I'm ready to believe that the Cavinton reception coincided with the improvement, but we tried to stop the reception many times, after that the speech objectively became less distinct as usual.

It's clear now. The statement would not hurt. It is difficult to imagine this situation. Why with acute pain in the abdomen and in therapy. Inflammation of the intestines implies its death (if it is infrared), then this necrosis of the tissue (it is not blood supplying), all this after 3 months would lead to a catastrophe in the abdomen, even much earlier. YOU NEED TO HOSPITALIZE. And the diagnosis that will put your mom on admission write to the forum, if not difficult. And take the statement.

Dear (a) Susanin Venous thrombosisis present but it is not an independent disease, but only a complication of the underlying, often combined with arrhythmias, they also contribute to the formation of blood clots. There is heart failure, as well as atherosclerosis (obliterans for-I). chronic venous insufficiency and there may be insufficiency over a large range of circulatory system.
Firstly, it is not a fact that it is present, it is very difficult to determine in absentia.
Secondly, do not you confuse venous thrombosis with the arterial, I'm talking about the relationship with atherosclerosis and arrhythmias.

Please comment on taking nitrosorbide. Do I need to take it all the time? My mother has an upper pressure in the region of 100-110. In the manual, it is not recommended at low pressure.

Firstly, it is not a fact that it is present, it is very difficult to determine in absentia.
Secondly, do not you confuse venous thrombosis with the arterial, I'm talking about the relationship with atherosclerosis and arrhythmias.

Arterial thrombosis is acute. This is me to what may be a concomitant potology. The clinic speaks more for a venous (pain in the course of a swelling of the edema), intermittent claudication. A history of intestinal infarction.

Firstly, it is not a fact that it is present, it is very difficult to determine in absentia.
Secondly, do not you confuse venous thrombosis with the arterial, I'm talking about the relationship with atherosclerosis and arrhythmias.

Arterial thrombosis is acute. This is me to what may be a concomitant potology. The clinic speaks more for a venous (pain in the course of a swelling of the edema), intermittent claudication. A history of intestinal infarction.

Inflammation of the intestines implies its death (if it is infrared), then this necrosis of the tissue (it is not blood supplying), all this after 3 months would lead to a catastrophe in the abdomen, even much earlier.


1) It seems to me that conservative treatment was successful.
2) Maybe you need to be a geriatric specialist to assess the situation. The rate of development of necrosis varies, depends on the metabolism and reactivity of the body (this is me about 4 days with a "sharp stomach").
3) We were very lucky with lech. doctor, was lucky to have continued treatment, despite the fact that 85 percent of the small intestine was affected.

If you do not remove the body means it was not necessary. You do not need to be a gerontologist to understand that you need to turn to specialists. I wish you every success in your treatment.

I want to add that the operation was done not by the attending physician(so, just in case, maybe it's interesting). I got the impression that the doctor initially, from the time of diagnosis, was for conservative treatment.

If you do not remove the body means it was not necessary.


And, that, you could leave 15% thinintestines? or completely remove it? This option did not occur to me. I'm not a doctor, but I studied biology at school. now google. whether this is done. you have puzzled me. confused:

I want to add that the operation was done not by the attending physician(so, just in case, maybe it's interesting). I got the impression that the doctor initially, from the time of diagnosis, was for conservative treatment.

It can only be an impression. Can laparoscopy be performed?

You do not need to be a gerontologist to understand that you need to turn to specialists.


I note that the geriatric has mentioned NOT in connection with the current situation. Pardon me.

It can only be an impression. Can laparoscopy be performed?


No, it was a laparotomy. That is, she became laparotomy on the go. Assumed a sectoral (or segmental?) Thrombosis. They wanted to remove the affected part. They performed the operation according to vital indications, but it turned into a laparotomy (only drainage was made).

There is a strong impression that the initiatordiscussion deals with anything, but not the main thing - ensuring the inspection of the patient by an expert. In addition, other participants do not contribute at all to the obvious, theorizing on the topic "what am I clever" and forgetting to mention even a dozen rare, but not so impossible, variants of pathology that appear similarly.
IMHO, the development of the topic in the direction of laposcopy will not lead to a solution of the problem, and it is worthwhile to stop. At least until the results of a full-time examination and instrumental examination.

There is a strong impression that the initiator of the discussion is engaged in anything, but not the main thing - ensuring the examination of the patient by a specialist.

I, frankly, are somewhat geographically distant from the patient. (In the other hemisphere. :(
She decided in the morning (before the hospital) to clean the intestines. Well, the process dragged on. you see. was busy with visits to the toilet. But tomorrow morning I firmly promised to the hospital.

Kind time of the day, dear dav1972!
I apologize for the criticism,
but the fact is that reading your phrase
Asymmetric swelling is not necessarily a thrombosis. Other common causes: varicose veins (without thrombosis), lymphatic insufficiency.
made me feel deja vu.
A little less than a year ago, I would agree with you on Sabzh;)
Two main reasons forced me to change the attitude to the question ..
1. Harrison's Manual of Medicine, 16th edition, which says that Unilateral extremity edema is usually due to venous or lymphatic obstraction. (primary lymphedema, if we talk about "lymphatic insufficiency" (c) dav1972)
Note, it is lymphatic obstruction.
2. At the same time, there was one discussion in a friendly forum about the so-called. "lymphatic drainage" (with) michmed. )
(If it's interesting [Only registered and activated users can see links])
Thus, I believe that the very phrase "lymphatic insufficiency", in the context of differential diagnosis of the edema of the lower extremities, has no right to be.
Since, in the realities of domestic medicine,a number of internists, "lymphatic insufficiency" is allocated to a separate nosological unit: confused. or at least it is considered the cause of edema development, which leads away from solving real problems.
How do you think?

Yes, if DIAMAL does not object, I'll ask a question. Mom terribly worried about these "films" on the toes, I understand that this is "natoptyshi." Can any more correct name? It is clear that they are caused by the violation of circulation, the mother is saved by different folk methods. After staying in the hospital 3 months ago (I already wrote about what) the situation improved for a short while, especially for the legs of treatment was not carried out. Now it's worsened again. how to escape from this? Most likely the topic was already, tell me the address, plz.

DIAMAL does not mind. And also, without mastering the method of monolateral transmonatory observation, refrains from answering.

P.P.S. It is not clear why only one leg?: Bn: Is there no venous insufficiency and thrombophlebitis on the second one?


Maybe because the left swelling is not enough expressed?


Tell me, where does your mother live?

I'm not sure that this is ethical in relation toGorbolnitsa, spread the name of the city on the forum, tk. I mentioned some errors. And a personal message - please ([Only registered and activated users can see the link])).

In my opinion, a good therapist is needed.
Outpatient or in a hospital, urgently or routinely - I can not decide on the presented data.
I can not imagine the possibilities of health facilities.
To my mother, in this state I would not be allowed to stay!