Concurrence of symmetrical peripheral gangrene and venous limb gangrene following polytrauma: a case report

Journal of Medical Case Reports
Jih Huei TanTheodore E Warkentin

Abstract

Symmetrical peripheral gangrene is characterized as acral (distal extremity) ischemic limb injury affecting two or more extremities, without large vessel obstruction, typically in a symmetrical fashion. Risk factors include hypotension, disseminated intravascular coagulation, and acute ischemic hepatitis ("shock liver"). In contrast, venous limb gangrene is characterized by acral ischemic injury occurring in a limb with deep vein thrombosis. Both symmetrical peripheral gangrene and venous limb gangrene present as acral limb ischemic necrosis despite presence of arterial pulses. The coexistence of symmetrical peripheral gangrene and venous limb gangrene is rare, with potential to provide pathophysiological insights. A 42-year-old Chinese man presented with polytrauma (severe head injury, lung contusions, and right femur fracture). Emergency craniotomy and debridement of right thigh wound were performed on presentation. Intraoperative hypotension secondary to bleeding was complicated by transient need for vasopressors and acute liver enzyme elevation indicating shock liver. Beginning on postoperative day 5, he developed an acute platelet count fall (from 559 to 250 × 109/L over 3 days) associated with left iliofemoral deep vein t...Continue Reading

References

Jan 1, 1996·World Journal of Surgery·D T EngelmanL M Jacobs
Feb 12, 1998·Annals of Internal Medicine·T E WarkentinJ G Kelton
Apr 26, 2001·The New England Journal of Medicine·T E Warkentin, J G Kelton
Feb 13, 2004·Tropical Doctor·B D SharmaB Gupta
Jun 16, 2009·Journal of the European Academy of Dermatology and Venereology : JEADV·S K GhoshA Ghosh
Mar 10, 2012·Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society·Robyn C Reed
Feb 19, 2013·BMJ Case Reports·Hamoun RozatiYing Ying Peng
Feb 27, 2014·The American Journal of Medicine·Andrew N RosenbaumJohn A Heit
May 28, 2014·BMJ Case Reports·Nasar AbdaliMehtab Ahmad
Jan 16, 2015·Seminars in Thrombosis and Hemostasis·Theodore E Warkentin
Aug 13, 2015·The New England Journal of Medicine·Theodore E Warkentin
Sep 18, 2015·Journal of Medical Case Reports·Chen-Yi LiaoChing-Chang Lee
Sep 26, 2015·International Journal of Surgery Case Reports·Pho Nh PhanAmjad Shad
Oct 8, 2016·Advanced Biomedical Research·M L PatelRadhey Shyam

❮ Previous
Next ❯

Citations

Jul 25, 2019·Journal of Thrombosis and Haemostasis : JTH·Jerrold H LevyTheodore E Warkentin

❮ Previous
Next ❯

Methods Mentioned

BETA
amputation
amputations

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.