The Intercontinental Journal of Emergency Medicine aims to publish issues related to all fields of emergency medicine and all specialties involved in the management of emergencies in the hospital and prehospital environment of the highest scientific and clinical value at an international level and accepts articles on these topics. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

EndNote Style
Case Report
Bedside ultrasonography in diagnosing bilateral femoral arterial occlusion in an elderly patient with acute limb ischemia
Non-traumatic acute limb ischemia is a critical vascular emergency that can lead to limb loss or life-threatening complications1. It is predominantly caused by arterial occlusions due to thrombi or emboli. Our report highlights the pivotal role of bedside ultrasonography in the emergency diagnosis of acute limb ischemia, exemplified by a case of bilateral femoral arterial occlusion. An 83-year-old woman with a medical history of atrial fibrillation, not on anticoagulation therapy, presented to the emergency department with increased right knee pain and dizziness. Initial examination revealed palpable peripheral pulses and sensitivity on knee palpation without overt signs of ischemia. However, subsequent systemic examination, prompted by the patient’s worsening agitation and pain, revealed coldness, pallor, and weakened pulses in both lower extremities. Bedside ultrasonography confirmed the presence of thrombi in both femoral arteries. The patient underwent successful emergency thrombectomy and was discharged with full recovery after appropriate management of atrial fibrillation. This case underscores the importance of vigilant systemic re-examination and the utility of bedside ultrasonography in the rapid diagnosis of acute arterial occlusion, particularly in patients with risk factors such as atrial fibrillation. Emergency physicians should consider acute limb ischemia in the differential diagnosis of patients presenting with non-specific symptoms like dizziness and localized pain, especially when coupled with a history of cardiovascular risk factors.

1. Ouriel K, Veith FJ, Sasahara AA. A comparison of recombinanturokinase with vascular surgery as initial treatment for acute arterialocclusion of the legs. N Engl J Med. 1998;338(16):1105-1111.
2. Walker TG. Acute limb ischemia. Tech Vasc Interv Radiol. 2009;12(2):117-129.
3. Rolston DM, Saul T, Wong T, Lewiss RE. Bedside ultrasound diagnosisof acute embolic femoral arteryocclusion. J Emerg Med. 2013;45(6):897-900.
4. Piotr S. Acute Arterial Occlusion. In: Gerhard-Herman, eds. VascularMedicine: Braunwald Accompanies Heart Disease. Elsevier: 2017:686-725.
5. Bloom B, Gibbons R, Brandis D, Costantino TG. Point-of-careultrasound diagnosis of acute abdominal aortic occlusion. Clin PractCases Emerg Med.2020;4(1):79-82.
6. Collins R, Burch J, Cranny G, et al. Duplex ultrasonography, magneticresonance angiography, and computed tomography angiographyfor diagnosis and assessment of symptomatic, lower limb peripheralarterial disease: systematic review. BMJ. 2007;334(7606):1257.
7. Met R, Bipat S, Legemate DA, Reekers JA, Koelemay MJW. Diagnosticperformance of computed tomography angiography in peripheralarterial disease: a systematic review and meta-analysis. JAMA.2009;301(4):415-424.
8. Chen HC, Liang HW, Yang PJ. Man with bilateral lower limbsnumbness.Ann Emerg Med.2023;81(4):438.
Volume 2, Issue 2, 2024
Page : 44-46