Year : 2021  |  Volume : 8  |  Issue : 6  |  Page : 162-164

Four limb gangrene - A rare presentation

1 Department of General Surgery, Gadag Institute of Medical Sciences, Gadag, Karnataka, India
2 Department of Forensic Medicine and Toxicology, ESIC Medical College and PGIMSR, Bengaluru, Karnataka, India

Correspondence Address:
V Vijayanath
Department of Forensic Medicine and Toxicology, ESIC Medical College and PGIMSR, Bengaluru, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijves.ijves_18_21

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We report a case of a 73-year-old male, who presented with acute gangrene of the left thumb which then progressed to symmetrical peripheral gangrene of digits of all four limbs, with no comorbid diseases. On investigation, there was high D-dimer, normal lipid profile, and two-dimensional Echo. Computed tomography and magnetic resonance angiogram of all limbs revealed atherosclerotic changes. The patient underwent disarticulation of digits under the wrist block. Symmetrical peripheral gangrene, seen in a wide variety of medical conditions presents as symmetrical gangrene of two or more extremities without large vessel obstruction or vasculitis. The fingers and toes (rarely nose, ear lobes, or genitalia) are affected. It may manifest unpredictably in conditions associated with sepsis, diabetes mellitus, low-output states, vasospastic conditions, myeloproliferative disorders, or hyperviscosity syndrome. It carries a high mortality rate with a very high frequency of multiple limb amputations in survivors.

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