[Critical considerations on paradoxical gangrene after sympathetic denervation]

Examination of numerous cases of lumbar gangionectomy has shown that paradoxical gangrene forms a particular complication, the origin of which has been discussed at length. It is felt that haemodynamic changes induced by the operation are predisposing factors, while personal experience suggests that thrombosis is responsible for the underlying acute vascular insufficiency in the immediate postoperative period. Evidence for this view is presented in the form of a case of iliac thrombosis following gangionectomy, in which disobstruction was necessary.