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Category: Volume 05 Issue 12 December 2017
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Title: Left lower Limb Gangrene Following Diarrhoeal Disease and Dehydration in a child with Transposition of the Great Arteries

Authors: Sani UM, Oboirien M, Waziri UM, Isezuo KO, GarbaBI, Oyibo E.

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i12.23

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. 

Keywords: Gangrene, Transposition of Great Arteries, Diarrhoeal Disease, Dehydration, Sokoto, Nigeria.

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Corresponding Author

Dr Sani, Usman Muhammad

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