Treatment of Fingertip Gangrene in a Patient with Raynaud’s Phenomenon who Simultaneously Underwent Gastrectomy and Chemotherapy for Gastric Carcinoma: A Case Report
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3
Abstract
Raynaud’s phenomenon, characterized by recurrent vasospasm in the fingers and toes, is a common clinical disorder encountered by dermatologists. Hand-arm vibration syndrome is well known to cause secondary Raynaud’s phenomenon. The goal of treatment is to improve microcirculation and decrease inflammation, platelet activation, and vasospasm. We have reported a chronic case of Raynaud’s phenomenon in a 46-year-old aboriginal man with gastric carcinoma who simultaneously underwent gastrectomy and chemotherapy. The patient had developed gangrene at the tip of the right index finger and toes previously, and his fingers and toes had been amputated. The patient was hesitant to have another finger amputated. Hence, he was administered a combination therapy of pentoxifylline, extended-release nifedipine, and low molecular weight dextran for treating the acute symptoms of Raynaud’s phenomenon. At the later stages of his disease, only extendedrelease nifedipine was administered. Treatment with nifedipine resulted in an improvement in the symptoms.Raynaud’s phenomenon is a common clinical disorder encountered by dermatologists. This condition usually occurs in response to exposure to cold temperature or emotional stress, and it is characterized by recurrent vasospasm in the fingers and toes. Hand-arm vibration syndrome (HAVS) is a well-recognized cause of secondary Raynaud’s phenomenon. The pathogenesis of HAVS involves a complex interplay of vascular, neural, and intravascular effects, and its pathologic characteristics include fibrosis and vasoconstriction [1]. The goal of treatment is to improve microcirculation and decrease inflammation, platelet activation, and vasospasm. Infusion of low molecular weight dextran (LMWD) has been successful in treating systemic sclerosis with Raynaud’s phenomenon without any adverse effects [2]. Buell [3] reported the successful resolution of fingertip ulceration with pentoxifylline and nifedipine in a case of secondary Raynaud’s phenomenon caused by HAVS. Here, we have reported a case of chronic Raynaud’s phenomenon in a patient who simultaneously underwent gastrectomy for gastric carcinoma and chemotherapy.
Authors and Affiliations
Yi-Shan Chen, Wei-Tso Chia
Keywords
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- EP ID EP569583
- DOI 10.26717/BJSTR.2017.01.000254
- Views 164
- Downloads 0
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