Dego's disease is a rather rare disease that begins with skin symptoms and often ends with a fatal outcome when an “acute abdomen” appears. It begins with the appearance on the skin of recurrent light pink. few edematous papular rashes, the central part of which after a while noticeably retracts. At this time, they become white. They are localized most often on the torso and the skin of the nape. At this stage, the changed tissues are rejected, and in their place ulcers with a rim of hyperemia open. After a few weeks, the patient has a sharp pain in the right epigastric region, fever, vomiting of blood. Attacks of pain appear after eating. After almost every attack, profuse diarrhea appears . Constant pain is accompanied by adynamia, a breakdown and exhaustion of the patient. Patients develop proteinemia, hypotension, bilirubinemia. The blood picture in patients is usually normal. After the appearance of such symptoms, a fatal outcome can occur within a few days. During autopsy, intestinal vein thrombosis and intestinal necrosis without perforations are detected.
Dego's disease is a cutaneous abdominal syndrome in which doctors almost always give a poor prognosis. Rashes in this disease usually consist of several elements that have different stages of development. Papules exist for about a month, and a scar is formed over a period of 0.5 years.
During histological studies in the dermis of the patient, serious changes in the vascular system are noted. So often there are blood clots, arteriolitis, endotheliitis, blockage of large and small vessels. In the collagen tissues around the affected vessels and on their walls, foci of fibrinoid necrosis are observed. In small capillaries, thromboendothelitis occurs. At the site of atrophic sites, collagen is highly densified, and the epidermis is covered with scales and thinned. In the circumference of the papular formations, dilated vessels are observed, which are surrounded by lymphohistiocytic infiltrate. Dego's disease also captures larger vessels located deep in the subcutaneous tissue and dermis. This process with multiple infiltrates and degeneration of the vessels of the intestines, skin and other organs is very similar to nodular panarteritis.
Although Dego's disease in the case of acute development has a poor prognosis, there are also cases with a long course that can be treated. The disease is treated with antibiotics, blood transfusions, corticosteroids, heparin, vitamins, antihistamines. With an "acute abdomen", the treatment practically does not give positive results.
Any vascular disease, especially in senile people, can have very serious consequences. Atherosclerotic changes sometimes affect the entire vascular system. In case of damage to the coronary and carotid arteries, vessels of the extremities, restenosis of the artery, it is recommended to perform an operation such as vascular stenting. Such a procedure is especially indicated for high risk of myocardial infarction, circulatory disorders in the brain, impaired limb function, trophic changes.
Stenting is contraindicated in case of small diameter of arteries (less than 2.5 mm), diffuse stenosis (for large areas of vasoconstriction), renal and respiratory failure, pathologies in the blood coagulation system, allergies to iodine-containing preparations (used in contrast radiological preparation).
Before the operation, such studies of the patient's body are carried out: ultrasound intravascular examination, ultrasound dopplerography, angiography, computed tomography, MRI, electroencephalography, echocardiography, electrocardiography. Before the operation, antiplatelet drugs are taken to reduce the risk of thrombotic complications.
The vascular stenting operation is performed under local anesthesia, performed in the area of the large artery on the leg or arm. For surgery, a radial, femoral, or thoracic artery can be used. The surgeon punctures the wall of the peripheral artery and inserts an introducer into it (a tube through which other instruments are inserted).
A thin catheter delivers a stent with a balloon through peripheral vessels to the desired artery. In the spray bottle is a contrast radiological substance. It stretches and the stent, which is a folded, mesh metal structure, is straightened. The whole operation is reflected on the monitor screen. The stent is fixed by pressing it into the walls of the artery. Several stents can be installed at the same time. Then the instruments are pulled out of the lumen in the vessel. The operation lasts about an hour. The patient practically does not feel pain, and discomfort appears only at the time of balloon inflating. After surgery, the patient is left in the hospital for several days. At this time, antiplatelet, antibacterial, anti-inflammatory therapy is prescribed.
Possible complications after surgery: damage to the walls of the arteries, hematomas at the puncture site, bleeding, clogged arteries, impaired renal function, allergic reactions, thrombosis of the stent.