Document Detail

Gangrene of toes with normal peripheral pulses.
MedLine Citation:
PMID:  843122     Owner:  NLM     Status:  MEDLINE    
Ten patients with pregangrenous and gangrenous changes of the toes in the presence of normal peripheral pulses are described. In the absence of diabetes this is an uncommon condition and is only rarely reported upon in the literature. Four patients had non occlusive arteriosclerotic changes in large arteries; three suffered from thrombocytosis and one from polycythemia vera; one patient had a monoclonal gamopathy and one was exposed to cold three months before the onset of gangrene. None of these patients smoked regularly. Severe pain usually preceded the gangrene. The process did not progress proximally in any patients, and in those who underwent toe amputations the healing was uneventful. Vasodilators and low-molecular dextran were not effective. Lumbar sympathectomy was performed in three patients, also with no effect on the course of the disease. Treatment of hematological disorders gave relief in three patients. Proximal arteriosclerotic changes should be corrected if possible to eliminate a source of emboli. In two patients anti-platelet aggregation agents provided relief. Toe amputation should be conservative and performed when definite demarcation appears between necrotic and viable tissue. This condition has a benign prognosis.
R Walden; R Adar; M Mozes
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  185     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1977 Mar 
Date Detail:
Created Date:  1977-04-15     Completed Date:  1977-04-15     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  269-72     Citation Subset:  AIM; IM    
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MeSH Terms
Arteriosclerosis / diagnosis
Busulfan / administration & dosage
Collateral Circulation*
Diabetic Angiopathies / diagnosis
Embolism / diagnosis
Frostbite / diagnosis
Gangrene / diagnosis*,  surgery
Middle Aged
Polycythemia Vera / diagnosis
Thrombocytosis / diagnosis
Toes / blood supply*
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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