Raynaud's disease

Surgical diseases

Raynaud's disease is an angiotrophoneurosis with a predominant lesion of small terminal arteries and arterioles. The process is localized on the upper limbs, the lesion is usually symmetrical and bilateral, more often young women fall ill.

Etiology: long-term fever, chronic finger traumatization, endocrine disorders (thyroid, sex glands), severe emotional stress.

Symptoms: 3 stages of the disease are distinguished: angiospastic (short-term spasms of the vessels of the terminal phalanges of 2-3 fingers of the hand or 1-3 fingers of the foot, the spasm is quickly replaced by the expansion of the vessels with reddening of the skin, warming of the fingers); Angioparalytic (the brush and fingers acquire a cyanotic color, puffiness and paleness of the fingers); Trophoparalytic (a tendency to develop panaricians and ulcers, foci of superficial necrosis of soft tissues of terminal phalanges, after rejection - long-lasting non-healing ulcers).

Differential diagnosis is carried out with obliterating endarteritis and circulatory disorders in the limb due to compression of the subclavian artery (an additional cervical rib, a highly located first rib - rib-subclavian syndrome, hypertrophied anterior staircase - a syndrome of the anterior staircase, a pathologically altered small pectoral muscle). With these syndromes there is compression of the subclavian artery and brachial plexus, hence the symptomatology of vascular and neurological disorders: pain, chilliness, paresthesia, weakness of the arm muscles. At certain positions of the hand, there is an increase in symptoms and a decrease in the pulsation of the vessels on the hand. Permanent traumatization of the artery leads to scarring of its wall, periarteritis and can result in thrombosis.

Treatment of Raynaud's disease is conservative, as with other obliterating diseases of blood vessels. In the absence of effect, a thoracic sympathectomy is produced, with necrosis - necrectomy. The courses of plasmapheresis with complete replacement of the removed plasma with fresh frozen plasma are shown.