L’échographie doppler dans la prévention des amputations des membres inférieurs du diabétique en Côte d’Ivoire

Abstract

ObjectiveThe aim of this study was to demonstrate the role of the Doppler ultrasound examination in the management of diabetic feet and particularly in the prevention of the diabetic's amputation. Patients and methodIt is about a retrospective study carried out over a 4-year period at Yopougon University Hospital (Abidjan, Côte d’Ivoire). It consisted in the analysis of the records of 78 patients hospitalized for diabetic foot and in whom was performed a Doppler ultrasound examination of the lower limbs vessels. The analysis of patients’ records helped to bring out the epidemiological, clinical, radiographic, biologic, therapeutic and evolutional elements. ResultsPatients’ mean age was 57.6 years. The sex ratio was 1.05. Adult diabetes accounted for 93.5% of cases and had been developing for 11.49 years on average. On the Doppler ultrasound scan of the lower limbs arterial anomalies of these limbs were found in 70 cases. They were associated with a venous anomaly in four cases. Arterial anomalies were represented by stenosis (34 cases), occlusions (10 cases), medialarterosclerosis (four cases), small arteries (six cases) and the associations of several elementary lesions (nine cases). In three cases, the arterial abnormality was not indicated. A medical treatment was instituted for all the patients. The outcome was favorable for 61 patients, 13 were amputated and four deaths were recorded. ConclusionColor Doppler ultrasound examination of lower limbs vessels helped to bring out a vascular anomaly in 89.7% of patients with diabetic foot whose treatment helped to keep the lower limb in 78.2%. We recommend the systematic request of this examination in the African diabetic with adult diabetes which has been developing for more than 10 years before the onset of diabetic foot.