Case 3 - Acute Ischemic Leg

68 years old gentleman presented to the ED with 2 days history of off and on right leg discoloration. Today he developed some pain, which had become worse over the last few hours. On arrival to the ED he had severe pain with obviously pale leg. The patient had no past medical history.

On examination he had normal observations. The right leg was obviously discolored (pale) and absent pulses from popliteal level and below. The bedside ultrasound was performed which showed:


                         case3-1.jpg  case3-2.jpg

Pic 1&2: 3.5 cm abdominal aortic aneurysm.



           Pic 3: Rt Popliteal Artery Aneurysm


         Pic 4: Lt Popliteal Artery Aneurysm


Popliteal aneurysms occur in up to 10% (10 in 100) patients with an aortic aneurysm. Bilateral popliteal aneurysms occur in about 40-50% of patients and about 40-50% of patients will have an associated aortic aneurysm. Most patients (95%) are elderly men with a median age of about 71 years.