Symmetrical peripheral gangrene-a case report and brief review

Rajgopal Shenoy, Namrata Agarwal, Umesh Goneppanavar, Anitha Shenoy, Ankur Sharma

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

A 30 year-old gentleman presented to casualty with history of pain abdomen for six days, fever and decreased urine output since two days. He was in a state of septic shock and was diagnosed to have intestinal perforation. His peripheral pulses were not palpable except for the femoral and brachial vessels. Despite fluid resuscitation, he needed infusion of high doses of dopamine and noradrenaline to maintain his blood pressure. He was operated for repair of perforation. On the first postoperative day, in the intensive care unit, vasopressin infusion was added in view of persistent hypotension. Appropriate fluid resuscitation and antibiotic therapy helped to wean him off inotropes and vasopressors by the second postoperative day. On the 3rd postoperative day, however, the patient developed discolouration and blebs on the fingers of left hand, followed by the right hand and then both the lower limbs. Subsequently, over a period of 10 days, this progressed to gangrene formation in the hands despite the patient being haemodynamically stable without any inotropes or vasopressors in this period. We conclude that the septic shock is a systemic derangement affecting all organ systems including coagulation and microcirculation. Early recognition and promptmanagement of sepsis, optimisation of fluid status to wean off the inotropes and vasopressors at the earliest is necessary to avoid catastrophes such as symmetrical peripheral gangrene.

Original languageEnglish
Pages (from-to)163-165
Number of pages3
JournalIndian Journal of Surgery
Volume75
Issue number1 SUPPL.
DOIs
Publication statusPublished - 10-2013

Fingerprint

Gangrene
Hand
Septic Shock
Resuscitation
Intestinal Perforation
Blister
Microcirculation
Thigh
Vasopressins
Abdomen
Hypotension
Fingers
Intensive Care Units
Lower Extremity
Dopamine
Sepsis
Norepinephrine
Arm
Fever
Urine

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Shenoy, Rajgopal ; Agarwal, Namrata ; Goneppanavar, Umesh ; Shenoy, Anitha ; Sharma, Ankur. / Symmetrical peripheral gangrene-a case report and brief review. In: Indian Journal of Surgery. 2013 ; Vol. 75, No. 1 SUPPL. pp. 163-165.
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Symmetrical peripheral gangrene-a case report and brief review. / Shenoy, Rajgopal; Agarwal, Namrata; Goneppanavar, Umesh; Shenoy, Anitha; Sharma, Ankur.

In: Indian Journal of Surgery, Vol. 75, No. 1 SUPPL., 10.2013, p. 163-165.

Research output: Contribution to journalArticle

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