“Ülceras cutáneas en insuficiencia venosa en pacientes con falla renal crónica”

Abstract

Male patient of 75 years of age, married, driver, born and resident of Coca, with a personal history of chronic renal insufficiency without treatment, venous insufficiency without treatment, arterial hypertension, without family, surgical or allergies. Patient is admitted to the surgery service from an outpatient clinic in the Coca hospital, since from 4 months he has pain in the lower limbs with a predominance of the right leg, of moderate intensity, as an apparent cause of having been in water at rest, as well as polyuria and nocturia from 3 months ago, it was accompanied by pruritus that ended up causing excoriations until reaching ulceration 3 months ago. To the patient physical examination consents, oriented, hydrated, FC 80, FR 20, systolic BP 120/80 diastolic mmHg, SO2 92% ambient air, T 37,6 C Skin and phantoms slightly pale, moist oral mucosal. Expandable, normal cardiopulmonary Thorax without added noises.Abdomen: Soft depressable painful to palpation in hypogastrium.Lower limbs: hyperpigmented skin Rots 2/5. Edema (++ / ++++) depression of up to 4mm and disappearance in 15 seconds that leaves no fovea with flushing and local heat, presence of ulcers in right leg in anterolateral side of lukewarm with purulent exudate of delimited edges excavated from granulomatous background. Exams: Ecodoppler of lower limbs reports chronic venous insufficiency. Blood chemistry reports creatinine of 3.36 mg / dl, urea of 81 mg / dl. Kidney echo and urinary tract: Kidney Right size and normal position of regular edges, homogeneous texture with increased echogenicity, several cystic images are visualized inside, small images of lithiasis are visualized towards its lower calyx of 0.60 cm not dilatation of the excretory duct. Left Kidney: retains its normal position, irregular contours increased its normal echogenicity, presence of renal cyst to its lower pole measuring 2.94 x 3.72cm, no dilation of its excretory system.