Compression of the Common Femoral Artery by a Lymphangioma Causing Intermittent Claudication

A Rare Case of Limb-Threatening Injury Secondary to Extrinsic Vascular Compression Following Crocodile Bite

Crocodile bites lead to fatal and nonfatal outcomes in humans. Mugger crocodiles (Crocodylus palustris) and saltwater crocodiles (Crocodylus porosus) are common in India. Most crocodile bites can cause severe injuries, especially to the extremities, due to the substantial bite force of the crocodile, which typically leads to extensive tissue damage, fractures, amputations, and vascular injuries. We report the case of a crocodile bite victim who presented with features of acute limb ischemia, was found to have vascular thrombosis of the common femoral artery, and was experiencing complete compression of the femoral vein due to external vascular compression by a hematoma. We discuss various injury mechanisms sustained in crocodile bites and the roles of point-of-care ultrasound and continuous tomography angiography, which could help identify these injuries. After thrombectomy and hematoma evacuation the patient recovered and was discharged without any physical dysfunction.

Acute lower limb ischaemia secondary to intestinal occlusion

In general, acute lower limb ischaemia is caused by embolic, thrombotic or traumatic phenomena. Here, we describe the case of a 67-year-old woman in an emergency room setting who was initially assessed for paralysis and numbness of her lower left limb. On physical examination, the abdomen was distended and non-compressible. An abdominal AngioScan showed complete occlusion of the left iliac artery by extrinsic compression of the dilated small intestine. After a review of the literature, no case was found describing a lower limb ischaemia by extrinsic vascular compression secondary to a compartment syndrome caused by small bowel obstruction. The treatment of this case required surgical decompression of the abdomen which led to an instantaneous reperfusion of the left leg. Unfortunately, the patient deceased a few hours after the surgery due to haemodynamic deterioration.

Intermittent claudication caused by a giant atypical lipoma of the thigh

The main cause of intermittent claudication in lower limbs is peripheral vascular disease. Less commonly, the etiology can be extrinsic to vascular structures, as in the cases of tumors that, due to their rapid growth, can reduce the blood supply and produce intermittent claudication during gait. We report the case of a 49-year-old patient with intermittent claudication in the left lower limb, reporting the presence of a tumor in the inner side of the left thigh with rapid growth. Doppler and angiography magnetic resonance imaging examinations demonstrated the presence of an adipose tumor that was producing deep and superficial extrinsic compression of the femoral arteries.