Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 6 , ISSUE 2 ( July-December, 2019 ) > List of Articles


Distal Ischemia of the Four Limbs: A Case Report and Literature Review

Hector Masaragian, Leonel Rega, Nicolas Ameriso, Fernando Perin, Hernan Coria, Luciano Mizdraji, Sabrina Cicarella

Keywords : Bone infarction, Distal ischemia, Norepinephrine, Sepsis, Symmetrical peripheral gangrene

Citation Information : Masaragian H, Rega L, Ameriso N, Perin F, Coria H, Mizdraji L, Cicarella S. Distal Ischemia of the Four Limbs: A Case Report and Literature Review. J Foot Ankle Surg Asia-Pacific 2019; 6 (2):46-51.

DOI: 10.5005/jp-journals-10040-1107

License: CC BY-NC 4.0

Published Online: 01-06-2020

Copyright Statement:  Copyright © 2019; The Author(s).


The symmetrical peripheral gangrene syndrome is characterized by ischemic distal lesions in two or more extremities, without the obstruction of large vessels. The ischemia affecting extremities takes place when the arterial blood flow is insufficient to satisfy the metabolic demands of muscles in rest. We present a 22-year-old patient treated with norepinephrine after a septic shock suspicion who presented distal ischemia of fingers, toes, and scalp. There is no consensus about the initial treatment. Improved data gathering is necessary for a better understanding of the mechanisms involved, which could improve treatment and prevent amputation as the final therapeutic option.

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