Skin Necrosis following Extravasation during Peripheral Phlebography

Abstract

Skin necrosis is an unusual complication following venography of the legs. The authors have found only four cases in the English literature. Two cases of skin necrosis following extravasation of contrast medium are reported. Their pathogenesis, clinical course, and treatment are discussed along with methods of prevention.

Utility of Venography in Shunt Surgery on Hemodialyzed Patients

“…There are a number of reports of complication in lower extremity venography [11,12], but we encountered no complications in any case in the present study. Re presentative examples of such complications are postvenographic venous thrombosis, contrast medium extra vasation and anaphylactic shock.…”

Extravasation Due to Intravenous Automated Injection of Contrast Media in the Dorsal Hand: Three-Dimensional MDCT Reformation Findings

“…The higher risk of extravasation from the venous circulation during contrast-enhanced CT when administered using a power injector with cases of substantial skin necrosis (Spigos et al, 1977) are well documented (Miles, Rasmussen, Litweller, & Osik, 1990).…”

“…The involved limb was elevated, and cold compresses were applied to the site (Spigos, Thane, & Capek, 1977). The patient was closely monitored.…”

Extravasation of intravenous contrast into the mediastinum

“…1 Nonetheless, extravasation into soft tissues can lead to localised tissue necrosis and may ultimately require surgical debridement. 4,13,14,17 Although the precise mechanism of contrast-related cutaneous and subcutaneous toxicity is not known, it is hypothesised that the hyperosmolality of contrast media along with mechanical compression are primarily responsible. 7 The pathogenesis postulated in extravasation injuries relates to the osmolality, the cytotoxicity, the volume and mechanical pressure generated by the fluid.…”