Auto-amputation is the spontaneous detachment of gangrenous or non viable tissue from the viable part. Mainly occurs due to occlusion of the nurturing vessels of the extreme body parts such as digits. Chronic and persistent hypoxia and the gangrene formation is the most common pathology. This kind of autoamputation are very common in rural India.
Atherosclerosis is the most common cause, other vessels causes include Buerger’s disease, frost bite. Other causes include Diabetic gangrene , ESRD i.e. cryoglobulinemia.
A 65 years female, chronic smoker for 30 years presented with spontaneous disarticulation of fingers and toes over last 4 years . Initially it started with bluish discolouration of the finger tips and toes which started paining and gradually progressed to numbness, ulceration and amputation.
On examination she was pale and showed bilateral feeble radial pulses and bilateral absent of popliteal pulses. Her digits were absent on the both feet and exposed metatarsals were seen. Her fingers were shortened on the both hands. Her Hb% was 7.9% and RBS was 220 mg%. she had blood pressure 140/90 mmHg and PR was 65 bpm. Doppler study of all the limbs and HBA1C were advised but reports yet to come.
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