Cargando…

Successful resolution of symmetrical peripheral gangrene after severe acute pancreatitis: a case report

INTRODUCTION: Symmetrical peripheral gangrene is an uncommon but devastating complication in critically ill patients, and it has a high mortality. It is seen in a wide variety of medical conditions, presenting as symmetrical gangrene of two or more extremities without large blood vessel obstruction....

Descripción completa

Detalles Bibliográficos
Autores principales: Liao, Chen-Yi, Huang, Shih-Chung, Lin, Cheng-Hui, Wang, Chih-Chiang, Liu, Mei-Yu, Ben, Ren-Jy, Kuo, Wu-Hsien, Lee, Ching-Chang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573942/
https://www.ncbi.nlm.nih.gov/pubmed/26376919
http://dx.doi.org/10.1186/s13256-015-0688-3
_version_ 1782390535948861440
author Liao, Chen-Yi
Huang, Shih-Chung
Lin, Cheng-Hui
Wang, Chih-Chiang
Liu, Mei-Yu
Ben, Ren-Jy
Kuo, Wu-Hsien
Lee, Ching-Chang
author_facet Liao, Chen-Yi
Huang, Shih-Chung
Lin, Cheng-Hui
Wang, Chih-Chiang
Liu, Mei-Yu
Ben, Ren-Jy
Kuo, Wu-Hsien
Lee, Ching-Chang
author_sort Liao, Chen-Yi
collection PubMed
description INTRODUCTION: Symmetrical peripheral gangrene is an uncommon but devastating complication in critically ill patients, and it has a high mortality. It is seen in a wide variety of medical conditions, presenting as symmetrical gangrene of two or more extremities without large blood vessel obstruction. CASE PRESENTATION: We report a case of a 44-year-old Chinese man who was diagnosed with alcohol-related severe acute pancreatitis and presented with systemic inflammatory response syndrome and intractable vomiting. On the fourth day of admission, the patient developed cyanosis and gangrene of the fingers bilaterally. His cyanosis and gangrene did not resolve despite tapering of the vasopressor treatment. Gradually, his digital gangrene improved after administration of anti-platelet medication and pentoxifylline. CONCLUSIONS: To the best of our knowledge, this is the first case report of symmetrical peripheral gangrene occurring after acute pancreatitis with successful resolution. We highlight the importance of prompt and aggressive fluid resuscitation and consideration of multiple treatment options to prevent a hypovolemic state caused by acute pancreatitis.
format Online
Article
Text
id pubmed-4573942
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-45739422015-09-19 Successful resolution of symmetrical peripheral gangrene after severe acute pancreatitis: a case report Liao, Chen-Yi Huang, Shih-Chung Lin, Cheng-Hui Wang, Chih-Chiang Liu, Mei-Yu Ben, Ren-Jy Kuo, Wu-Hsien Lee, Ching-Chang J Med Case Rep Case Report INTRODUCTION: Symmetrical peripheral gangrene is an uncommon but devastating complication in critically ill patients, and it has a high mortality. It is seen in a wide variety of medical conditions, presenting as symmetrical gangrene of two or more extremities without large blood vessel obstruction. CASE PRESENTATION: We report a case of a 44-year-old Chinese man who was diagnosed with alcohol-related severe acute pancreatitis and presented with systemic inflammatory response syndrome and intractable vomiting. On the fourth day of admission, the patient developed cyanosis and gangrene of the fingers bilaterally. His cyanosis and gangrene did not resolve despite tapering of the vasopressor treatment. Gradually, his digital gangrene improved after administration of anti-platelet medication and pentoxifylline. CONCLUSIONS: To the best of our knowledge, this is the first case report of symmetrical peripheral gangrene occurring after acute pancreatitis with successful resolution. We highlight the importance of prompt and aggressive fluid resuscitation and consideration of multiple treatment options to prevent a hypovolemic state caused by acute pancreatitis. BioMed Central 2015-09-17 /pmc/articles/PMC4573942/ /pubmed/26376919 http://dx.doi.org/10.1186/s13256-015-0688-3 Text en © Liao et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Liao, Chen-Yi
Huang, Shih-Chung
Lin, Cheng-Hui
Wang, Chih-Chiang
Liu, Mei-Yu
Ben, Ren-Jy
Kuo, Wu-Hsien
Lee, Ching-Chang
Successful resolution of symmetrical peripheral gangrene after severe acute pancreatitis: a case report
title Successful resolution of symmetrical peripheral gangrene after severe acute pancreatitis: a case report
title_full Successful resolution of symmetrical peripheral gangrene after severe acute pancreatitis: a case report
title_fullStr Successful resolution of symmetrical peripheral gangrene after severe acute pancreatitis: a case report
title_full_unstemmed Successful resolution of symmetrical peripheral gangrene after severe acute pancreatitis: a case report
title_short Successful resolution of symmetrical peripheral gangrene after severe acute pancreatitis: a case report
title_sort successful resolution of symmetrical peripheral gangrene after severe acute pancreatitis: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573942/
https://www.ncbi.nlm.nih.gov/pubmed/26376919
http://dx.doi.org/10.1186/s13256-015-0688-3
work_keys_str_mv AT liaochenyi successfulresolutionofsymmetricalperipheralgangreneaftersevereacutepancreatitisacasereport
AT huangshihchung successfulresolutionofsymmetricalperipheralgangreneaftersevereacutepancreatitisacasereport
AT linchenghui successfulresolutionofsymmetricalperipheralgangreneaftersevereacutepancreatitisacasereport
AT wangchihchiang successfulresolutionofsymmetricalperipheralgangreneaftersevereacutepancreatitisacasereport
AT liumeiyu successfulresolutionofsymmetricalperipheralgangreneaftersevereacutepancreatitisacasereport
AT benrenjy successfulresolutionofsymmetricalperipheralgangreneaftersevereacutepancreatitisacasereport
AT kuowuhsien successfulresolutionofsymmetricalperipheralgangreneaftersevereacutepancreatitisacasereport
AT leechingchang successfulresolutionofsymmetricalperipheralgangreneaftersevereacutepancreatitisacasereport