title: Is Achenbach's syndrome a surgical emergency? A systematic review.
abstract: OBJECTIVE
  The aim of this study is to establish the nature (urgent vs. non-urgent), demographics, presentation and management of Achenbach's syndrome and to formulate an algorithmic approach for their diagnosis and management.
  
  
  METHODS
  A systematic review and met-aggregation of literature from 1944 to 2015 in English language in MedLine, Embase and Cochrane database were conducted.
  
  
  RESULTS
  Achenbach's syndrome is a female-dominant disease with median age of 49.5 years (range 22-76) (age ≤60, n = 11/12, 91 %). It presents with unilateral volar discoloration of a finger (100 %). It is associated with pain (n = 7/12, 58. %), edema (n = 7/12, 58 %), and paresthesia (n = 3/12, 25 %). The median time to resolution of symptoms without any intervention was 4 days (range 2-14).
  
  
  CONCLUSIONS
  AS is self-limiting and a non-urgent surgical condition. It can be differentiated from other pathologies by clinical spectrum, patient demographics and in doubtful circumstances (acute limb ischemia) by Doppler sonography. An algorithmic approach can avoid hospital admissions, partially unnecessary investigation and assist in patient assurance.
authors.affiliation: Department of Vascular and Endovascular Surgery, Mid Essex Hospital Services NHS Trust, Essex, UK. Alikordzadeh@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Kordzadeh
authors.affiliation: Department of Vascular and Endovascular Surgery, Mid Essex Hospital Services NHS Trust, Essex, UK.
authors.forename: P L
authors.initials: PL
authors.lastname: Caine
authors.affiliation: Department of Vascular and Endovascular Surgery, Mid Essex Hospital Services NHS Trust, Essex, UK.
authors.forename: A
authors.initials: A
authors.lastname: Jonas
authors.affiliation: Department of Accident and Emergency, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Court Road, Essex, CM1 7ET, UK.
authors.forename: K M
authors.initials: KM
authors.lastname: Rhodes
authors.affiliation: Department of Vascular and Endovascular Surgery, Mid Essex Hospital Services NHS Trust, Essex, UK.
authors.forename: Y P
authors.initials: YP
authors.lastname: Panayiotopolous
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D000792:Angiography; D003937:Diagnosis, Differential; D005385:Fingers / Q000098:blood supply* / Q000473:pathology; D006225:Hand / Q000098:blood supply* / Q000473:pathology; D006406:Hematoma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006474:Hemorrhagic Disorders / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D013577:Syndrome
keywords: Achenbach syndrome; Algorithmic approach; Diagnostic tools; Differential diagnosis; Management; Systematic review