Leriche's syndrome

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A disturbance causing impotence, pain and fatigue in men.

Description

A disturbance usually affecting young males caused by atheromatous involvement or occlusion of the abdominal aorta by a thrombus just above the site of its bifurcation (obliteration of both A. iliacae communes). The main symptoms are inability to maintain penile erection, fatigue in the lower limbs, cramps in the calf area, ischemic pain of intermittent bilateral claudication; absent or diminished femoral pulse, pallor and coldness of the feet and legs. Onset usually between 30 and 40 years of age.

First described in 1814 by Robert Graham (1786-1845), then physician at the Royal Infirmary in Glasgow, later professor of Botany in Glasgow.

Leriche first operated for "his" syndrome on a 29 year old truck driver who for two years had been suffering from claudicatio intermittens with severe cramps in the leg musculature already after a few hundred meters of walking, and cramp pains also at night. The last weeks before the operation he complained of not being able to complete an intercourse, as both erection and ejaculation was disturbed. At a control 18 years later the patient was fully capable of working and had a 14 year old son.

Bibliography

  • R. Graham:
    Case of obstructed aorta. Communicated by Sir G. Blane.
    [Sir Gilbert Blane, 1747-1834 ] Medico-Chirurgical Transactions, London, 1814.
  • R. Leriche:
    De la résection du carrefour aortico-iliaque avec double sympathectomie lombaire pour thrombose artéritique la l’aorte: le syndrome de l’oblitération termino-aortique par artérite.
    La presse médicale, Paris, 1940, 48: 601-607.

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