Document Detail

Symmetrical peripheral gangrene.
MedLine Citation:
PMID:  14959959     Owner:  NLM     Status:  MEDLINE    
Symmetrical peripheral gangrene (SPG), seen in a wide variety of medical conditions presents as symmetrical gangrene of two or more extremities without large vessel obstruction or vasculitis. Fingers, and toes (rarely nose, ear lobes or genitilia) are affected. It may manifest unpredictably in conditions associated with sepsis, low output states, vasospastic conditions, myeloproliferative disorders or in hyperviscosity syndrome. It carries a high mortality rate with a very high frequency of multiple limb amputations in survivors. Disseminated intravascular coagulation (DIC) is seen in majority of cases of SPG. A more or less stereotyped clinical picture of SPG in spite of ever widening aetiological spectrum is suggestive of DIC as the final common pathway of its pathogenesis. Early recognition of acrocyanosis, quick reversal of DIC, effective management of the underlying condition, haemodynamic stabilization and (perhaps) anticoagulation with low dose heparin (300-500 iu/hour) may be helpful in arresting the progression of pre-gangrenous changes to frank gangrene. Vasopressors such as dopamine should be used judiciously in the presence of DIC. Development of acrocyanosis and increase in serum lactate levels may be indicative of impending SPG and the imperative need to treat DIC as well as the underlying condition.
B D Sharma; S R Kabra; B Gupta
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Tropical doctor     Volume:  34     ISSN:  0049-4755     ISO Abbreviation:  Trop Doct     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-02-12     Completed Date:  2004-04-06     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  1301706     Medline TA:  Trop Doct     Country:  England    
Other Details:
Languages:  eng     Pagination:  2-4     Citation Subset:  IM    
Department of Medicine,VM Medical College & Safdarjung Hospital, New Delhi, India.
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MeSH Terms
Fingers / pathology*
Gangrene / diagnosis*,  drug therapy*,  etiology
Toes / pathology*

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

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