We report three cases of symmetrical peripheral gangrene (SPG) caused by septic shock. Most of sepsis survivors with SPG require amputation of the affected extremities. To preserve the length of the thumb and fingers, we performed surgical amputation and used flaps to cover the amputated peripheral extremities.

SPG (Symmetrical peripheral gangrene) is defined as symmetrical distal ischemic damage at two or more sites in the absence of large vessels obstruction. It has been ascribed to a number of infectious and non infectious conditions including connective tissue, cardiovascular, neoplastic and iatrogenic causes. We report a unique case of SPG in a 35-year-old Indian female who developed spontaneous ...

At this stage, we noticed bluish discoloration of all upper limb fingers [Figure 1], which was soon noticed in lower limb toes also. All peripheral pulses were palpable and of normal volume. Patient has a borderline cardiac output (3.8 L/min) and cardiac index (2.1 L/min/m2). A clinical diagnosis of systemic peripheral gangrene (SPG) was made. We started milrinone 0.3 μg/Kg/min at this point fo...

A 74-year-old manwas admitted with abdominal discomfort, fever and chills in the previous 2 weeks. Physical examination revealed a vague Murphys’ sign on abdominal palpation. Abdominal ultrasonography demonstrated a distended gallbladder and acute cholecystitis was initially diagnosed. He underwent a laparoscopy and multiple caseous nodules over the peritoneal cavity were found. Histopathologic...