Document Detail


Venous gangrene of the extremities.
MedLine Citation:
PMID:  7922898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review the rare clinical condition of venous gangrene of the extremities, particularly in association with malignant disease; to develop a treatment scheme for this difficult condition. DATA SOURCES: Surgical articles on phlegmasia cerulea dolens, venous gangrene and other forms of noninfectious, nonarterial gangrene of the extremities from 1937 to the present were identified from published indexes and computer databases; experience with four additional cases treated by the authors is incorporated. STUDY SELECTION: Studies selected for detailed review include those involved directly with venous gangrene and its investigation and treatment, and those relating to investigation of clinically similar conditions. DATA EXTRACTION: Because of the rarity of venous gangrene, much of the available literature is descriptive, involves small numbers of cases and describes only limited experience with investigation and treatment; data extraction was done by a single reviewer. DATA SYNTHESIS: Because of advances in diagnostic technology and thrombosis research, the assessment of suspected venous gangrene has changed significantly in recent years. Despite these advances, the prognosis for patients with this condition continues to be poor. The possible confounding roles of paradoxical reactions to anticoagulants and of primary hypercoagulable states are considered. CONCLUSIONS: Objective demonstration of extensive thrombosis of the large veins of the involved extremity remains central to the diagnosis. The presence and stage of any associated malignant lesion must be rapidly determined to allow planning for further treatment. Because conventional anticoagulation frequently fails, it may be necessary to consider less well-established modes of therapy.
Authors:
J W Lorimer; L C Semelhago; G G Barber
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Canadian journal of surgery. Journal canadien de chirurgie     Volume:  37     ISSN:  0008-428X     ISO Abbreviation:  Can J Surg     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-11-10     Completed Date:  1994-11-10     Revised Date:  2007-08-16    
Medline Journal Info:
Nlm Unique ID:  0372715     Medline TA:  Can J Surg     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  379-84     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Ottawa, Ont.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / surgery
Aged
Amputation
Anticoagulants / therapeutic use
Arm / blood supply
Female
Gallbladder Neoplasms / surgery
Gangrene
Humans
Leg / blood supply,  surgery
Male
Pancreatic Neoplasms / surgery
Postoperative Complications / pathology*
Pulmonary Embolism / etiology,  pathology
Thrombophlebitis / drug therapy,  etiology*,  surgery
Uterine Neoplasms / surgery
Chemical
Reg. No./Substance:
0/Anticoagulants
Comments/Corrections
Comment In:
Can J Surg. 1994 Oct;37(5):368-9   [PMID:  7922893 ]
Can J Surg. 1995 Apr;38(2):190   [PMID:  7728676 ]

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


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