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Oh, Lee, Moon, and Yoon: Symmetrical Peripheral Gangrene after Pulmonary Hemorrhage
Case Report
Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2010; 45(6): 482-485.

Published online: 24 December 2010

DOI: https://doi.org/10.4055/jkoa.2010.45.6.482

Symmetrical Peripheral Gangrene after Pulmonary Hemorrhage

Hyun Cheol Oh, M.D., Jae Jeong Lee, M.D.*, Eun Su Moon, M.D.*, Han Kook Yoon, M.D.

Department of Orthopedic Surgery, National Health Insurance Corporation Ilsan Hospital, Ilsan, Korea.

*Department of Orthopedic Surgery, College of Medicine, Yonsei University, Seoul, Korea.

Correspondence to: Han Kook Yoon, M.D. Department of Orthopedic Surgery, National Health Insurance Corporation Ilsan Hospital, 1232, Baekseok-dong, Ilsan-gu, Goyang 411-360, Korea. TEL: +82-31-900-0540, FAX: +82-31-900-0343, hangugy@hanmail.net

Received 21 April 2010       Accepted 28 June 2010

Copyright © 2010 by The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Symmetrical peripheral gangrene (SPG) is characterized by distal ischemic damage in two or more extremities without a large vessel obstruction. This syndrome is associated with low cardiac output, sepsis, malignancy, disseminated intravascular coagulation (DIC) and the administration of vasoactive drugs. We report a case of SPG in a patient with pulmonary hemorrhage, sepsis and DIC who had been administered dopamine.

Keywords: syndrome of symmetrical peripheral gangrene, low cardiac output, sepsis, disseminated intravascular coagulation, dopamine

Figures and Tables

Figure 1
Initial computerized tomography shows pulmonary hemorrhage.
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Figure 2
At three months after admission, the gangrenous lesions involving four limbs were demarcated.
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Figure 3
(A) After the demarcation of the gangrenous left foot, open amputation was performed at Lisfranc joint level. Vacuum-Assisted Closure dressing material was applied to open wound. (B) In one month after amputation, the patient underwent gracillis free flap to the open lower leg and there was no flap loss after all.
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References

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