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Disseminated intravascular coagulation resulting in amputation. A case report
Insights
This case study details a patient with disseminated intravascular coagulation (DIC), an uncommon disease, who experienced amputation and required extensive prosthetic care. With ongoing management, the patient achieved limited community ambulation, with potential for full ambulation post-growth.
Area of Science:
- Medical Case Study
- Hematology
- Vascular Pathology
Background:
- Disseminated intravascular coagulation (DIC) is an uncommon but severe condition.
- Clinical presentation often includes systemic infection, skin lesions, shock, anemia, and renal failure.
- Amputation is a rare but reported complication of DIC.
Observation:
- The patient presented with multiple clinical features consistent with DIC.
- Acute systemic infection led to tissue pathology, necessitating amputation.
- Post-amputation, the patient developed skin complications during prosthetic training.
Findings:
- The patient required significant prosthetic modification and monitoring due to skin issues.
- Three skin grafts and two surgeries for heterotopic ossification were performed.
- The patient achieved limited community ambulation after intensive interventions.
Implications:
- Careful prosthetic management and monitoring are crucial for DIC patients with amputations.
- Long-term follow-up is essential for optimizing functional outcomes.
- Successful prosthetic rehabilitation can lead to improved community ambulation despite severe DIC complications.
Abstract:
This patient had many of the clinical features described in the literature as characteristic of DIC, an uncommon disease. These included the acute systemic infection precipitating the tissue pathology, ecchymotic skin lesions progressing to amputation, shock, anemia, and renal failure. The literature reported two case studies that resulted in amputation. During prosthetic training, both the patients developed skin problems that required prosthetic modification before they could wear their prostheses. The patient in our case study also required careful prosthetic modification with continual monitoring of the status of the skin. After three skin grafts and two surgical procedures to remove heteroptic ossification, the patient became a limited community ambulator (Fig. 4). When he attains full growth and the heteroptic bone formation subsides, we believe he should become a community ambulator, as long as he receives proper prosthetic care and follow-up.