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Gluteal Necrosis and Lumbosacral Plexopathy in a Diabetic Patient after Renal Transplantation.

Asgari MA, Masoumi N, Argani H - Case Rep Urol (2015)

Bottom Line: The main reason was ligation of internal iliac artery of the same side as a result of extensive microvascular obstruction due to severe atheromatous plaque.The gluteal necrosis is a serious complication which, as in our patient, resulted in patient's death in most of the reported cases.Because of catastrophic nature of this condition, identifying preventive measures is extremely important.

View Article: PubMed Central - PubMed

Affiliation: Urology Department, Shahid Modarres Hospital, Shahid Beheshti Medical University, Saadat Abad, Tehran 1998734383, Iran.

ABSTRACT
A 34-year-old diabetic patient underwent a renal transplant which was complicated by right side lower extremity paresis and numbness with gluteal necrosis. The main reason was ligation of internal iliac artery of the same side as a result of extensive microvascular obstruction due to severe atheromatous plaque. This is a rare complication which is mostly reported in aneurysmal patients after bypass surgery. The gluteal necrosis is a serious complication which, as in our patient, resulted in patient's death in most of the reported cases. Because of catastrophic nature of this condition, identifying preventive measures is extremely important.

No MeSH data available.


Related in: MedlinePlus

Necrotic site in the right hip which progressed to a large ulcer in the following days.
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fig1: Necrotic site in the right hip which progressed to a large ulcer in the following days.

Mentions: On postoperative day 2, he complained of pain and inability to move his right leg since the night before. On physical exam, there was an ischemic area 2 × 2 cm in diameter on the right hip. This ischemic area progressed to a large necrotic area 7 × 7 cm in the following days (Figure 1). Neurologic exam revealed diminished strength in hip flexion (3/5) and knee extension (3/5) with 4/5 strength in ankle dorsiflexion and plantar flexion and toe extension. Sensation was poor in all the right extremity and the patellar and ankle reflexes were lost. He also had no urine and fecal control. EMG study documented profound sensorimotor polyneuropathy and right lumbosacral plexopathy. Lower limb Doppler US was unremarkable.


Gluteal Necrosis and Lumbosacral Plexopathy in a Diabetic Patient after Renal Transplantation.

Asgari MA, Masoumi N, Argani H - Case Rep Urol (2015)

Necrotic site in the right hip which progressed to a large ulcer in the following days.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4697094&req=5

fig1: Necrotic site in the right hip which progressed to a large ulcer in the following days.
Mentions: On postoperative day 2, he complained of pain and inability to move his right leg since the night before. On physical exam, there was an ischemic area 2 × 2 cm in diameter on the right hip. This ischemic area progressed to a large necrotic area 7 × 7 cm in the following days (Figure 1). Neurologic exam revealed diminished strength in hip flexion (3/5) and knee extension (3/5) with 4/5 strength in ankle dorsiflexion and plantar flexion and toe extension. Sensation was poor in all the right extremity and the patellar and ankle reflexes were lost. He also had no urine and fecal control. EMG study documented profound sensorimotor polyneuropathy and right lumbosacral plexopathy. Lower limb Doppler US was unremarkable.

Bottom Line: The main reason was ligation of internal iliac artery of the same side as a result of extensive microvascular obstruction due to severe atheromatous plaque.The gluteal necrosis is a serious complication which, as in our patient, resulted in patient's death in most of the reported cases.Because of catastrophic nature of this condition, identifying preventive measures is extremely important.

View Article: PubMed Central - PubMed

Affiliation: Urology Department, Shahid Modarres Hospital, Shahid Beheshti Medical University, Saadat Abad, Tehran 1998734383, Iran.

ABSTRACT
A 34-year-old diabetic patient underwent a renal transplant which was complicated by right side lower extremity paresis and numbness with gluteal necrosis. The main reason was ligation of internal iliac artery of the same side as a result of extensive microvascular obstruction due to severe atheromatous plaque. This is a rare complication which is mostly reported in aneurysmal patients after bypass surgery. The gluteal necrosis is a serious complication which, as in our patient, resulted in patient's death in most of the reported cases. Because of catastrophic nature of this condition, identifying preventive measures is extremely important.

No MeSH data available.


Related in: MedlinePlus