engleski

Blue fingertips - a rare complication of acute necrotising pancreatitis

Background: Acute pancreatitis is sometimes life threatening illness with eventful complications. Extra pancreatic organ failure and development of local complications determine the course. Apart from well known local and systemic complications, vascular occlusion with cholesterol embolism has been established in various studies. Among different vascular complications, blue toe syndrome was described. Case report: A 81-year old man was admitted because of sudden onset of abdominal pain after a fatty meal. According to the laboratory and imaging findings the diagnosis of acute necrotic pancreatitis (Balthazar score D, CTSI 5) was established. Because of respiratory insufficiency and pleural effusions patient was transferred to the ICU and ventilated mechanically. His clinical condition improved. In clinical status we noticed development of painful blue discoloration in distal phalanges 2nd to 5th finger of his right hand. Color Doppler of the right forearm was done and showed no flow in distal parts of the mentioned fingers. In spite of the improvement of general clinical condition, patient unexpectidly died two days later. Autopsy revealed pulmonary embolism as cause of death. Conclusion: Although blue toe (tip) syndrome can occur as a complication in many diseases, we have to consider it as a very rare, but possible complication of acute pancreatitis too.

Blue fingertips; acute pancreatitis; complications

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