BENGALURU: Doctors are reporting cases of gangrene (death of body tissue due to lack of blood flow that affects limbs and sometimes internal organs as well) in post-COVID patients. If there is a delay in consultation, it could lead to amputation of a hand or leg and if part of the intestine is dead, that segment has to be removed.
Dr Venkatesh Reddy, consultant, Vascular and Endovascular Surgery, Manipal Hospitals, has seen 20 gangrene cases so far in the second wave.
"Gangrene affects the legs and toes, fingers and hands in the form of blackish discoloration and coldness. This is being seen in the second wave, in younger patients and is possibly linked to the COVID-19 variants which are presenting in an aggressive way. Within 6-8 hours the digits (finger, thumb or toe) can be preserved. However, many patients are referred late and it is not possible to dissolve the clot through thrombolysis or remove the clot through embolectomy. At that time, it is the worst case scenario and the body part has to be amputated."
Dr. Reddy said if gangrene has a cardiac effect, there are high chances of fatality. At Apollo Hospitals, Dr. Baskar Pai, senior consultant, general surgery and laparoscopic surgeon, has seen 5 to 6 cases in the recent past.
"Owing to blood clotting tendencies post COVID, patients suffer gangrene if the clot goes to the limbs, or internal organs such as intestines. They present with severe abdominal pain, vomiting, blood in motion, abdominal distention (bloating). Blood investigations and CT scan reveals gangrene. If they have it, we have to operate and remove that segment of the body which is dead. For example, it could be 12 feet of the intestine and then we have to rejoin the remaining part."
This could lead to short bowel syndrome and trouble in assimilation of food and digesting nutrition in the future. Gangrene has a high fatality rate especially if the doctors are unable to salvage a large part of the affected body part.
At Sakra World Hospital, Dr Sachin Kumar, senior consultant, pulmonology and critical care medicine received a case of thrombosis (blood clot blocks blood vessels) in the arteries supplying to the intestine leading to intestinal gangrene.
"The patient initially had vague symptoms like pain in abdomen, distension and rapidly progressed to a septic shock like condition and blood in vomiting, stools. This presentation is also most of the time under diagnosed and leads to grave outcome if not treated aggressively with anticoagulation and surgical intervention in a narrow period of time."
When secondary infection ensues, it often becomes difficult to salvage a limb and necessitates amputation in many cases.
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