Left lower Limb Gangrene Following Diarrhoeal Disease and Dehydration in a child with Transposition of the Great Arteries
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 12
Abstract
Background: Children with Cyanotic Congenital Heart Diseases are at risk of developing thrombosis and gangrene, especially when they suffer severe fluid loss or experience significant fluid restriction. Aim: To describe a case of a 2-year-old girl with transposition of the great arteries (TGA) who developed left lower limb gangrene following an episode of diarrhoeal disease. Case: HB presented with four-week history of progressive darkening of her left leg, which was preceded by two days history of diarrhea and vomiting. At presentation, she had moderate dehydration and central cyanosis (SpO2-68%), with signs of dry gangrene of the distal half of the left leg. Echocardiography confirmed d-TGA with ventricular and atrial septal defects. Packed cell volume was moderately elevated (57%), but blood culture result and other hematologic parameters were essentially normal. Patient had above-knee amputation of the left leg. She had eventful post-operative stay characterized by inter current fever and delayed wound healing (>4weeks). Unfortunately, the parents signed against medical advice despite counseling. Conclusion: Limb gangrene may complicate cyanotic congenital heart diseases such as TGA. Diarrhoeal disease, which causes dehydration and hyper viscosity, is a potential precipitant.
Authors and Affiliations
Dr Sani, Usman Muhammad
Keywords
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