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Related Experiment Videos

Symmetrical peripheral gangrene.

B D Sharma1, S R Kabra, B Gupta

  • 1Department of Medicine,VM Medical College & Safdarjung Hospital, New Delhi, India. bdsharma007@rediffmail.com

Tropical Doctor
|February 13, 2004
PubMed
Summary
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Symmetrical peripheral gangrene (SPG) affects extremities without vessel obstruction, often linked to disseminated intravascular coagulation (DIC). Early recognition and management of DIC and underlying conditions are crucial for survival and limb preservation.

Area of Science:

  • Vascular Medicine
  • Hematology

Background:

  • Symmetrical peripheral gangrene (SPG) is a critical condition affecting extremities, characterized by gangrene in multiple limbs without evidence of large vessel obstruction or vasculitis.
  • SPG can manifest in diverse clinical scenarios including sepsis, low output states, vasospastic conditions, myeloproliferative disorders, and hyperviscosity syndrome.
  • The condition is associated with high mortality and frequent limb amputations in survivors.

Purpose of the Study:

  • To elucidate the pathogenesis of SPG, highlighting the role of disseminated intravascular coagulation (DIC) as a common final pathway.
  • To emphasize the importance of early recognition and prompt management strategies for SPG.

Main Methods:

  • Review of clinical presentations and etiological spectrum of SPG.

Related Experiment Videos

  • Analysis of the association between SPG and disseminated intravascular coagulation (DIC).
  • Evaluation of potential therapeutic interventions for managing SPG and its underlying causes.

    • Main Results:

    • Disseminated intravascular coagulation (DIC) is observed in the majority of SPG cases, suggesting it as a unifying pathophysiological mechanism.
    • A consistent clinical presentation of SPG occurs despite a broad range of underlying etiologies.
    • Early signs like acrocyanosis and elevated serum lactate may herald impending SPG.

    Conclusions:

    • Prompt recognition of acrocyanosis and rapid reversal of DIC are vital for preventing progression to gangrene.
    • Effective management of the underlying condition, hemodynamic stabilization, and judicious use of vasopressors are essential.
    • Low-dose heparin anticoagulation may be beneficial in arresting pre-gangrenous changes.