Clinical Case of Treatment of the Patient with Martorell's Ulcer


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Abstract

Relevance "Hypertensive ischemic ulcer" was first described by the Spanish cardiologist Martorell in patients older age group with severe hypertension. Martorell syndrome is not well known to most practitioners, as "pure" form, as described by the author, is rare. Provoking moments can serve as scratching, trauma or other reasons, that the patient is not always able to recover his memory. Onset of the disease is characterized by the appearance of papules or area of red-bluish color, with a slight soreness, passing in expressions. Martorell shallow ulcers with granulation sluggish and scanty discharge, developing very slowly. The main distinguishing feature of these ulcers - constant excruciating pain. Patients put traditionally diagnosed "trophic ulcer". The basis of the diagnosis "Martorell ulcer" based on the following criteria: the presence of severe hypertension and stable constant pain in the ulcer, as well as the data of histological examination, during which the phenomena are endoarterialnoy proliferation and subendothelialhyalinosis
The purpose of the study Description of a case of treatment of the patient with an ulcer Martorell.
Materials and methods The patient presented with severe hypertension and the presence of ulcers on the left lower leg. In a survey of the diagnosis - a trophic ulcer of the left shin syndrome (Martorell). Coronary artery disease, angina, FC 2-3.Cardiosclerosis diffuse. Hypertension, Art. III, the risk of MTR 4. H2A. In the treatment of the correction of blood pressure, rheological, angiotropnaya, antibiotic therapy, topical treatment of wounds, physiotherapy. As a result, 3 weeks achieved complete epithelialization of trophic ulcers.
Conclusion The basis of a positive result of treating a patient with an ulcer Martorell is the correct diagnosis of the underlying disease and the subsequent complex therapy, including normalization of blood pressure, angioprotektory modern dressings.

About the authors

Russian FederationVoronezh State Regional Clinical Hospital, 151 Moskovskii Ave.,Voronezh, 394036, Russian Federation

Author for correspondence.
Email: Mashaaralova@mail.ru
Ph.D., Head. Department of outpatient surgery Voronezh Regional Clinical Hospital №1

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str.,Voronezh, 394036,

Email: surgery-v@yandex.ru
MD, Prof., Corresponding Member of the RANH, Head of the Department of General Surgery, Director of the Institute of Surgical Infection of N.N. Burdenko Voronezh State Medical Academy, Honored Inventor of the Russian Federation, Chairman of the Voronezh Branch of the Russian Society of Surgeons

References

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  2. Hafner J., Ramelet A., Schmeller W. et al.Ulcers management[Upravleniye yazvami]. Curr. Probl. Dermatol. Basel: Karger, 1999; 27: 4—7.

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