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Ischemic Gangrene


Presentation

  • PRESENTATION OF CASE We present 3 cases with spontaneous ischemic gangrene of the rectum.[ncbi.nlm.nih.gov]
  • The clinical, biochemical, radiological, and histological findings in the 8 patients who developed PIG while on maintenance dialysis (MD) are presented.[ncbi.nlm.nih.gov]
  • AYURVEDIC MANAGEMENT OF ISCHEMIC GANGRENE- DUE TO DIABETES MELLITUS – A CASE REPORT Medical science says that ischemia is a common complication in Diabetes, especially in the lower limb but this is a case presenting ischemic changes in upper limb which[climic.com]
  • To the Editor: Warkentin (Aug. 13 issue) 1 highlights the misconception that all cases of ischemic limb gangrene are associated with the loss of an arterial pulse and presents the two syndromes associated with disseminated intravascular coagulation in[nejm.org]
  • At present, tetanus almost always occurs in nonimmunized or partially immunized persons, and then only if they are late in seeking treatment or if the threat of possible tetanus infection is unrecognized by the physician.[jamanetwork.com]
Localized Edema
  • When a minor trauma occurs and local edema occludes a superficial branch of a small artery of the skin below it in the presence of neuropathy, a shallow neuro‐ischemic ulcer may form over the ischemic area.[onlinelibrary.wiley.com]
Localized Edema
  • When a minor trauma occurs and local edema occludes a superficial branch of a small artery of the skin below it in the presence of neuropathy, a shallow neuro‐ischemic ulcer may form over the ischemic area.[onlinelibrary.wiley.com]
Lower Abdominal Pain
  • EK A 93-year old otherwise very active male was admitted with lethargy and lower abdominal pain. He was constipated recently and took some laxatives, as a result he had diarrhea just before admission.[ncbi.nlm.nih.gov]
Hematemesis
  • A 65-year-old male diabetic (fasting blood sugar 166 mg/dl, postprandial blood sugar 240 mg/dl, HbA1c 8.1%) patient presented in emergency with complaints of hematemesis and melena for the past 24 h.[jpharmacol.com]
Hepatomegaly
  • On evaluation, he was found to have hepatomegaly. His hemogram showed anemia (8.9 g/dl), thrombocytopenia (platelet count 0.4 lac/mm 3 ) with evidence of coagulopathy (prothrombin time index 48%).[jpharmacol.com]
Foot Pain
  • I didn’t know what to expect as I had never been to a doctor for foot pain before. What I like best about your practice was how genuinely comfortable the entire staff made me feel and how Dr.[mt-podiatry.com]
  • Case 3 Two days after undergoing percutaneous intervention for an ST-elevation myocardial infarction, a 74-year-old woman developed right foot pain, increasing numbness and sensory deficit, and minimal weakness.[evtoday.com]
  • Criteria for diagnosis include either one of the following (1) more than two weeks of recurrent foot pain at rest that requires regular use of analgesics and is associated with an ankle systolic pressure of 50 mm Hg or less, or a toe systolic pressure[aafp.org]
  • When I ask him, he comments that he is sleeping well at night, without foot pain waking him up. I know when his toes were gangrenous and pain at night was a big problem for him.[reversegangrene.com]
Skin Ulcer
  • .- ) varicose ulcer ( I83.0- I82.2 ) Acrosphacelus I96 Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin) (ulcer) I96 - see also Necrosis abdomen I96 (wall) auricle I96 cutaneous, spreading I96 extremity I96 (lower) (upper) limb[icd10data.com]
  • ., shiny skin, hair loss, skin ulceration, skin/soft tissue necrosis, atrophy of muscle, and decreased pulse strength compared to the other limb). Frequently, a pulse will be palpable in an unaffected extremity and absent in the affected limb.[reliasmedia.com]
Pelvic Pain
  • Abdominal and pelvic pain and distention is also common. Fever, tachycardia along with hypotension is often present.[ncbi.nlm.nih.gov]
Neglect
  • […] induced by disturbance in Ketakalamine metabolism) and also hypo and hyper coagulation leads to thrombosis results in maargavarana by dusta rakta (This happened because of pittaja prameha pidaka in dusta rakta) and acharya charaka explains that if we neglect[cureveda.com]
Lethargy
  • EK A 93-year old otherwise very active male was admitted with lethargy and lower abdominal pain. He was constipated recently and took some laxatives, as a result he had diarrhea just before admission.[ncbi.nlm.nih.gov]

Workup

  • In most cases, patients undergo an extensive workup for obscure chronic abdominal pain before the patient is seen by a vascular surgeon. 3.2.[intechopen.com]

Treatment

  • Such a rare and interesting case was taken at Sri Sri Ayurveda Hospital and handled by proper Ayurvedic line of treatment by which circulation is re-established which saved both limb and life of patient. Here is the case report.[climic.com]
  • Photographs showing the various stages of Treatment.[cureveda.com]
  • The patient instead elected conservative treatment with analgesia, an antiplatelet agent, and management of his vascular risk factors.[nejm.org]
  • Hitchock CR, Haglin JJ, Arnar O (1967) Treatment of clostridial infections with hyperbaric oxygen. Surgery 62:759–769 Google Scholar 6. Littmann I (1977) Sebészeti Mütéttan. Medicina, Budapest Google Scholar 7.[link.springer.com]
  • The proper vascular treatment is major key in diabetic wound control. 7. The sufficient debridement with proper antibiotics could reverse the wound status.[link.springer.com]

Prognosis

  • De-identified demographic information and other patient specific information; According to a study titled Population based study of incidence, risk factors, outcome, and prognosis of Ischemic peripheral arterial events, the clinical burden of peripheral[cureveda.com]
  • In one particular study, patients with a poor prognosis responded well to Ceprotin therapy [ 4, 5 ]. In that similar study, no haemorrhage or thrombotic events were noted after the initiation of Ceprotin therapy [ 5 ].[archivesofmedicine.com]
  • Among the diabetic foot classification system, the IDSA classification reflects the infection severity and strong relationship with prognosis. 4.[link.springer.com]
  • Symmetrical peripheral gangrene has a poor prognosis. Mortality is said to approach 40%. The reason for this prognosis is usually the underlying disease. Local outcomes are also horrific.[angiologist.com]
  • Prognosis is highly variable, but can involve significant morbidity and mortality. Gangrene is a complication of necrosis characterized by the decay of body tissues.[us.bestpractice.bmj.com]

Etiology

  • Its etiology is obscure and in many cases no etiological factor can be found but the presence of ischemic changes at birth suggests an intrauterine etiopathogenesis.[jpss.eu]
  • […] produce similar changes as acute ischemia, may be segmental and patchy Epidemiology Usually age 50 years but also infants with necrotizing enterocolitis Intestinal ischemia occurs in 3% of renal transplant patients ( Arch Pathol Lab Med 2002;126:1201 ) Etiology[pathologyoutlines.com]
  • […] the diagnosis of acute mesenteric ischemia 10 ) arterial phase (e.g. triggered when abdominal aorta reaches 100 HU) portal venous phase, e.g. 30 seconds after arterial phase finishes Findings Imaging features can vary depending on the time course and etiology[radiopaedia.org]
  • Most important etiological agent of necrosis. Reduced oxygen supply most commonly due to vascular changes. However, also can be caused by chemical damage, CO poisoning.[quizlet.com]

Epidemiology

  • "Fournier's gangrene: Population based epidemiology and outcomes". The Journal of Urology. 181 (5): 2120–6. doi : 10.1016/j.juro.2009.01.034. PMC 3042351. PMID 19286224.[en.wikipedia.org]
  • Definition / general Ischemic changes may be mucosal, mural (due to hypoperfusion) or transmural (major vessels involved) Chronic ischemia may produce similar changes as acute ischemia, may be segmental and patchy Epidemiology Usually age 50 years but[pathologyoutlines.com]
  • Epidemiology The incidence of ischaemic colitis has risen from 6.1 cases/100 000 person-years in 1976-80 to 22.9/100 000 in 2005-09 [ 5 ]. Many mild cases may go unreported.[patient.info]
  • The epidemiology of diabetes in Korea: from the economics to genetics. Korean Diabetes J. 2010;34(1):10–5. PubMedCentral CrossRef PubMed Google Scholar 3. Lavery LA, et al. Risk factors for foot infections in individuals with diabetes.[link.springer.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology : Unlike ischemic colitis or proctitis, frank gangrene of the rectum is very rare.[ncbi.nlm.nih.gov]
  • […] factors in dry gangrene There are different pathways involved in the pathophysiology of dry gangrene ( Figure 1 ).[dovepress.com]
  • Pathophysiology [ edit ] Gas gangrene is caused by exotoxin -producing Clostridium species (most often C. perfringens, and C. novyi, [5] but less commonly C. septicum [6] or C. ramnosum ), [7] which are mostly found in soil, but also found as normal gut[en.wikipedia.org]
  • With better understanding of the clinical syndromes and the pathophysiological basis of AMI a multidisciplinary approach in management has emerged for patients with suspected mesenteric vascular disease.[intechopen.com]
  • We found a strong association between PC activity levels and 1/INR, which supports a key pathophysiological role for severe depletion of PC activity levels in predisposing to microvascular thrombosis.[bloodjournal.org]

Prevention

  • Preventability of the adverse drug reaction (ADR) was assessed by Schumock and Thronton's scale. [16] Moreover, this ADR was found to be of definitely not preventable category.[jpharmacol.com]
  • Clinicians must be vigilant for this complication and they should be reminded that it requires urgent management to prevent tissue loss. Figures and Topics from this paper. References Publications referenced by this paper.[semanticscholar.org]
  • Altemeier WA, Fullen WD (1971) Prevention and treatment of gas gangrene. J Am Med Assoc 217:806–813 CrossRef Google Scholar 2. Binder L, Budai J, Kátay A, Nyerges G (1981) Fertözö betegségek. Medicina, Budapest Google Scholar 3.[link.springer.com]
  • Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217–28. CrossRef PubMed Google Scholar 22. Aerden D, et al. The ankle--brachial index and the diabetic foot: a troublesome marriage. Ann Vasc Surg. 2011;25(6):770–7.[link.springer.com]
  • The chief problem in managing patients with severe ischemia of the foot is the prevention of gangrene and amputation.[jamanetwork.com]

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