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

Journal of Medical Case Reports

Ching-Chang Lee¹  Wu-Hsien Kuo¹  Ren-Jy Ben¹  Mei-Yu Liu¹  Chih-Chiang Wang¹  Cheng-Hui Lin¹  Shih-Chung Huang¹  Chen-Yi Liao¹ 

[1] Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan

关键词: Symmetrical peripheral gangrene (SPG);    Severe acute pancreatitis;    Low volemic state;   

Others  :  1231235
DOI  :  10.1186/s13256-015-0688-3

 received in 2015-02-05, accepted in 2015-08-21,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Liao et al.

【 图 表 】

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