THROMBOANGIITIS OBLITERANS (BUERGER’S DISEASE)

Abstract

Background Buerger disease or thromboangitis obliterans (TAO) is a non-atherosclerotic inflammatory disease (non-atherosclerotic inflammation) in which segmental occlusion occurs in small and medium arteries and in the upper and lower extremity veins. Classica l manifestations of TAO occur in male smokers with symptom onset aged <45 years. Affected individuals usually have a history of heavy
smoking using 20 cigarettes per day. In this case, it was found that patients were not in the age range where TAO often occurs. However, patients are men who have a smoking habit of more than 20 cigarettes per day.

Case Summary A 49-year-old male patient complained of pain in the tips of the fingers of both hands and left leg. Complaints begin to be felt by patients since 1 m onth before entering the hospital. Patients are active smokers. Patients say that in one day they can consume 1 -3 packets of cigarettes or around 15-45
cigarettes. The patient starts smoking since the age of 15 years. The last history of smoking is 1 month before entering the hospital. The patient also consumed alcohol but stopped. The patient complains of fever three days before hospitalization, chills and headaches. On physical examination found in the
region of the left pedis, there is a blackish necrosi s tissue on digital I, II and IV as high as the phalanx distal to the proximal phalanx, tenderness, palpation of the dorsalis pedis artery is not lifted.

Conclusion TAO is a different form of systemic vasculitis with no known etiology although it is strong ly associated with smoking. Diagnosis of Buerger's disease or obstruction of thromboangitis can be established by looking at the diagnosis criteria of Shionoya with ischemic symptoms, angiographic findings in the form of corkscrewshaped collaterals, and histopathological features of thrombus occlusion with infiltrates. polymorphonuclear leukocytes. In this patient combination therapy is performed. Surgery is the last step if the non-surgical procedure is unsuccessful. The most common surgical procedure performed is amputation. Prognosis depends on the cure rate and the level of recurrence in the patient.