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Case Report
Severe difficulties in management of rare aortoiliac occlusive disease in patient with comorbidity in primary health care. Is Leriche syndrome unrecognized enough? A case report
1 Private Family Medicine Practice, Slavonski Brod, Croatia
2 Department of Internal Medicine, Family Medicine and the History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
3 General Hospital Dr. Josip Bencevic, Slavonski Brod, Croatia
4 Postgraduate Interdisciplinary University Study – Molecular Biosciences, University of Josip Juraj Strossmayer, Osijek, Croatia
5 Department of Public Health, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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Zvonimir Bosnic
MD, PhD Student, Private Family Medicine Practice, Vatroslava Jagica 66B, Slavonski Brod 35 000,
Croatia
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Article ID: 100062Z09ZB2021
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How to cite this article
Bosnic Z, Kovacevic B, Vucic D, Kovacevic S, Marinic N, Guljas S, Majnaric LT. Severe difficulties in management of rare aortoiliac occlusive disease in patient with comorbidity in primary health care. Is Leriche syndrome unrecognized enough? A case report. J Case Rep Images Med 2021;7:100062Z09ZB2021.ABSTRACT
Introduction: Leriche’s syndrome, as a relatively rare aortoiliac occlusive disease, presents big challenge in every day practice because precise prevalence and incidence are still unknown. Identifying peripheral arterial disease (PAD) presents a challenge, as in 10% of patients, it may be asymptomatic and unrecognized. It is known that the prevalence of PAD increases in aging populations, and nowadays there are many diagnostic tests which are conducted in a number of different settings by health care professionals with varying experience of using assessment tools. There is lack of awareness of this rare condition in general practitioner (GP), and we report this case in order to highlight the importance of complex thinking of pain and claudication in family medicine practice in patients with comorbidity.
Case Report: A 56-year-old male, with a previous history of arterial hypertension, diabetes mellitus type 2, hyperlipidemia, nicotinism, and chronic obstructive pulmonary disease (COPD) presented to family medicine doctor with symptoms of strong pain and claudication in legs. Due to physical examination, the patient was admitted to emergency department for evaluating the onset of impalpability of bilateral femoral pulses. In order to define impalpability of femoral pulses, color Doppler imaging was performed, which confirmed stenosis. Computed tomography (CT) confirmed occlusion of the abdominal aorta and iliac arteries known as aortoiliac occlusive disease.
Conclusion: There is lack of current clinical guidelines which provide a practical framework for managing multimorbidity. In order to early detection of PDA, GPs must be aware that limited evidence suggests that all diagnostic tools accurately diagnose severity of PAD. There is need for developing register of rare condition for primary care to expand its role in prevention, early detection and control, and management within in rare vascular disorder.
Keywords: Aortoiliac occlusive disease, Leriche syndrome, Management of rare disease, Multimorbidity, Primary health care
SUPPORTING INFORMATION
Author Contributions
Zvonimir Bosnic - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Bozidar Kovacevic - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Domagoj Vucic - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Stjepan Kovacevic - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Nikica Marinic - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Silva Guljas - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Ljiljana Trtica Majnaric - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest
Copyright© 2021 Zvonimir Bosnic et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
