What is Lerish's syndrome?

Lerish's syndrome is a disease of the arterial system, which among pathologies of this type is most common. It consists in the defeat of the aorto-iliac region of the body, as a result of which blood supply in the pelvic region and legs sharply decreases.

This name was proposed by F. Morel in 1943, devoting him to the French surgeon Lerish, who actively investigated this malaise.

Lerish's syndrome leads to the appearance of three major disorders, which doctors call the "triad of symptoms." In patients with a violation of the blood supply to the aorta, there is intermittent claudication, the pulse in the lower parts of the legs disappears, impotence develops.

Today, statistics can not say exactly how often this disease occurs: it is not all doctors who diagnose it. However, indirect data (in particular, the number of operations to restore blood flow in the aorta) suggest that only in the United States this disease affects about forty thousand people a year.

The etiology of the disease is established. In 95% of cases, it is caused by obliterating atherosclerosis, in 4% - by nonspecific aortoarteritis, in others - by fibrous or muscular dysplasia of the arteries, aplasia or hypoplasia of the aorta, Postembolic occlusion, other diseases of the circulatory system.

The main reason, due to which Lerish syndrome develops - an occlusion (blockage) of the aorta, the blood flow in which stops due to the overlapping plaque.

It was found that men are the most vulnerable to the disease, especially after 45 years. The main risk factor is smoking.

How does the disease develop?

The main complaints are for pain in the legs. The specialists established that the ischemia of the lower extremities caused by the blood flow disturbance can have 4 stages of development:

• When the ailment is only beginning, pain in the legs occurs with strong or prolonged physical exertion, for example, walking for more than a kilometer.
• The second stage is characterized by the appearance of pain even under low loads.
• In the third stage, strong painful sensations worry patients even at rest.
• On the fourth there are trophic disorders: ulcers, gangrene, necrosis.

Lerish syndrome, whose treatment at the last stage involves amputation of the limbs, is always accompanied by severe pain in the buttocks, hips, waist, and often in the anal valve. The reason is the development of ischemia (insufficient blood supply) of the muscles of the small pelvis. This so-called intermittent claudication gradually increases, ischemia affects not only the pelvic floor, but also the spinal cord, which causes and rapidly develops impotence.

In addition to the above symptoms, the patients notice a very slow growth of the nails, fragility and abundant hair loss are observed, the toes turn black or bluish. In the absence of treatment, bluish outgrowth into gangrene.

To diagnose the disease, radiopaque angiography, ultrasound dopplerography is used.

Treatment of the disease without surgery, which is usually done in two stages, is ineffective.