Assessing limb ischaemia using Doppler in a patient with diabetes mellitus.

OBJECTIVE

To highlight the usefulness of duplex ultrasonography in assessing the degree of limb ischaemia in patients with peripheral arterial occlusive disease (PAOD).

METHODOLOGY: Duplex ultrasonography (B mode, Color flow and spectral Doppler analysis) was used to evaluate the degree of limb ischaemia in an elderly Nigerian woman with diabetes who had clinical features of severe PAOD

RESULTS

The patient was found to have moderate and severe limb ischaemia in the right and left lower limbs respectively. She subsequently had a below the knee amputation of the left lower limb.

CONCLUSION

Duplex ultrasound is advised as part of the pre-operative evaluation of patients with PAOD, in order to adequately localise the diseased arterial segment and degree of limb ischaemia. However, segmental Doppler pressures with ankle brachial analysis should be utilised as a screening tool in symptomatic patients.