Lesson of the month
Digital necrosis with Ogilvie's syndrome
a Department of Rheumatology, Royal Victoria
Hospital, Belfast , b Department of Urology, City
Hospital, Belfast
Correspondence to: Dr G D Wright, Rheumatology Department, City Hospital, Nottingham NG5 1PB.
Accepted for publication 21 January 1997
| The first 150 words of the full text of this article appear below. |
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Case report |
|---|
A 76 year old retired fisherman presented with a progressive four week history of cold, painful, blue fingers. Systematic enquiry was unremarkable apart from generalised lethargy over the preceding six weeks. He had osteoarthritis of his left hip and had taken indomethacin 25 mg thrice daily for five years. He was an ex-smoker of 20 cigarettes/day for 40 years.
On examination he was apyrexic. There was severe ischaemia of both hands with gangrene and necrosis of the fingertips (fig 1). Both feet were cyanosed, but there was no overt ischaemia or necrosis. All peripheral pulses were palpable with a blood pressure in both arms of 160/90. There were no large vessel bruits or cardiac murmurs. Abdominal distension was noted but there was no tenderness or organomegaly. His fundi were normal. The remainder of the physical examination was unremarkable.
| Figure Removed (Available Only in the Full Text) |
Laboratory investigations revealed a hypochromic, normocytic anaemia
with a haemoglobin of 9.4 g/dl and a
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