Arterial embolism

Abstract

A 65-year-old man presented with acute severe pain in his right leg. Medical history revealed non-insulin-dependent diabetes mellitus for 3 years and a myocardial infarction (MI) some 5 years ago. The pain in the right leg developed suddenly over 6 h without associated trauma and became worse over time. On admission, the right leg looked pale distally from the level of the knee. There was loss of light touch sensation on examination of the foot. The patient had difficulties in wiggling the toes. Plantarflexion and dorsiflexion of the toes were still possible. Palpation of the calf showed soft but tender muscles. Clinical examination of the abdomen showed no abnormalities. There was no pulsating mass. Irregular but bounding pulsations were felt in the right femoral artery. Popliteal artery and tibial artery pulsations were absent. Normal pulsations were felt in the left popliteal and posterior tibial artery.