SURGICAL DISEASES, TRAUMATOLOGY, ORTHOPEDICS, UROLOGY : THE SYMMETRICAL GANGRENE DRY (RAYNAUD'S DISEASE) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Irritation vasomotor nerve fibers caused by trauma, infection, often unclear. Spasms of peripheral blood vessels are observed more often on the fingers, it is possible and on the toes and ears; they are usually symmetric. In the further development of the disease to spasm join trophic disorders and tissue necrosis.
Symptoms. Under the influence of cooling, agitation, and sometimes without apparent reason one or more fingers turn pale, getting kind of dead. After a few minutes ghastly color of the finger goes in congestive hyperemia. Patients during the attack noted the presence of numbness, tingling, unpleasant, sometimes painful sensations. In further seizures numbness become more rare, but there are persistent pain, persistent bluish coloring brush, lowering its temperature, swelling and surface of flickery with serous-purulent discharge. Pain can acquire significant intensity - develop pockets of dry necrosis of the phalanges of the fingers with the demarcation and exclusion plots gangrene. The latter is usually dry in nature, limited and symmetric. The pulsation of the arteries are usually saved. Not uncommon General disorders of the cardiovascular system.
Course and complications. Seizures may recur regularly with varying frequency (from several times per day to once in several months), not progressing, long breaks. Often, the disease does not develop further, first and second stage. May develop sclerodermia phenomena with dermatogenic contractures of the fingers.
Recognition is facilitated when the typical localization and typical picture. The localization of the lower extremities should be differentsirovat from obliterating thromboangiitis.
Removal of possible intoxication, physical therapy, both local (diathermy), and the overall effect on the nervous system (ultraviolet irradiation).In more severe cases, and at inclinations to the development of gangrene - surgical treatment (blocking or deletion of the starry host, transection rami communicantes and periarterial sympathectomy).