Bilateral ischemic necrosis of the tongue due to disseminated intravascular coagulation

Kamatani, Takaaki; Yamashita, Koichi; Okabayashi, Takehiro; Maeda, Hiromichi; Toi, Makoto; Yamamoto, Tetsuya

doi:10.1016/j.ijom.2008.03.001

Cited by 15 publications

(10 citation statements)

References 9 publications

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“…The differential diagnoses of tongue necrosis also include several hypercoagulable disease states. One case has been reported of tongue necrosis in a patient with disseminated intravascular coagulation, during the early consumptive coagulation phase 16. Another case of ischemic tongue necrosis occurred in a patient with essential thrombocytosis 17.…”

Section: Discussionmentioning

confidence: 99%

Ischemic necrosis of the tongue in patients with cardiogenic shock

2010

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Objectives/Hypothesis Ischemic necrosis of the tongue is a rare entity generally associated with vasculitis. Critically ill patients with shock might experience hypoperfusion of head and neck end organs including the tongue. Study Design Retrospective analysis of hospital charts. Methods Case histories and photographs of five patients who developed ischemic tongue necrosis in the context of cardiogenic shock. Results Five critically ill patients in our institution’s cardiothoracic intensive care unit developed ischemic necrosis of the tongue. All five patients experienced protracted courses of profound cardiogenic shock requiring high-dose vasopressor support and urgent cardiac surgery. Three patients required intraaortic balloon pumps. All patients had concomitant signs of poor end organ perfusion, including lower extremity ischemia and renal and hepatic failure. Ultimately, four of five patients died, with one patient surviving after sloughing of the entire oral tongue. Conclusions Ischemic necrosis of the oral tongue is an uncommon but perhaps under-reported manifestation of end organ hypoperfusion in shock, likely signifying poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Ischemic necrosis of the tongue in patients with cardiogenic shock

2010

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“…Other causes such as APS may require anticoagulant treatment. In previously reported cases of extensive necrosis a conservative approach was adopted, as with our patient 5 6. These cases had a high mortality rate related to extensive comorbidities.…”

Section: Discussionmentioning

confidence: 94%

“…Case reports also exist of other causes of lingual necrosis including vasopressor use, radiotherapy, antiphospholipid syndrome, disseminated intravascular coagulation, fungal infection and secondary to carotid artery stenosis 2–4 6 9 10. A case series has also been published recently documenting lingual necrosis secondary to severe hypotension in cardiogenic shock.…”

Section: Discussionmentioning

confidence: 99%

“…Other reports of lingual necrosis exist secondary to vasopressor use, radiotherapy and antiphospholipid syndrome (APS) 2–4. Reports of bilateral ischaemia are rare but have been reported in relation to severe hypotension or disseminated intravascular coagulation 5 6. We present a case of bilateral lingual ischaemic necrosis presenting in a 61-year-old patient as an acutely swollen tongue threatening the airway.…”

Section: Introductionmentioning

confidence: 95%

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Ischaemic necrosis of the tongue

McGoldrick¹,

Khan

Cotter

2015

BMJ Case Reports

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Necrosis of the tongue is a rare clinical finding. The rich vascularity of the tongue means necrosis is uncommon but it has been reported secondary to giant cell arthritis, radiotherapy and ischaemia. We report the case of a 61-year-old man admitted with an acute abdomen, who later developed gross swelling of the tongue, secondary to ischaemic necrosis, which necessitated tracheostomy placement. The ischaemia was managed conservatively with heparinisation and by allowing the ischaemic area to demarcate and slough off naturally.

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“…Other causes of tongue ischemia include hyperviscosity syndrome, radiation effects, carotid dissection, and disseminated intravascular coagulation. [6][7][8][9] Although symptoms such as jaw pain with chewing may become manifest with ligation of one or both external carotid arteries, circulation to the face is well preserved because of abundant collateral flow. In our case, however, severe stenosis in the contralateral external carotid artery and embolization to the ipsilateral lingual artery abruptly compromised the limited collateral flow to the tongue, resulting in tissue necrosis.…”

Section: Discussionmentioning

confidence: 99%

Tongue necrosis as an unusual presentation of carotid artery stenosis

Bjordahl

Ammar

2011

Journal of Vascular Surgery

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A 57-year-old man with premature coronary artery disease presented to the emergency department with left facial pain, numbness, and tongue swelling. The patient was found to have significant tongue necrosis, and subsequent arteriography demonstrated carotid bifurcation stenosis with embolization to the left lingual artery. The patient was successfully treated with debridement of his tongue and left carotid endarterectomy.

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Bilateral ischemic necrosis of the tongue due to disseminated intravascular coagulation

Cited by 15 publications

References 9 publications

Ischemic necrosis of the tongue in patients with cardiogenic shock

Ischemic necrosis of the tongue in patients with cardiogenic shock

Ischaemic necrosis of the tongue

Tongue necrosis as an unusual presentation of carotid artery stenosis

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