Digital gangrene and pneumatosis intestinalis associated with calciphylaxis

• Published in: Journal of vascular surgery cases and innovative techniques Vol. 4; no. 2; pp. 133 - 135
• Main Authors: Kawaji, Qingwen, Eller, Erik Brian, Yee, Jerry, Lin, Judith C.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2018; Elsevier
• Subjects: Case report
• ISSN: 2468-4287; 2468-4287
• DOI: 10.1016/j.jvscit.2018.02.007

Reports of calciphylaxis or calcific uremic arteriolopathy associated with acral and gastrointestinal involvement are rare. We describe a 36-year-old white woman with end-stage renal disease on hemodialysis after failed kidney and pancreas transplantation who developed dry gangrene of bilateral digits, osteomyelitis, and small bowel ischemia within several months of each presentation. She had multiple débridements of a septic right ankle. Computed tomography angiography showed severe vascular calcification and pneumatosis intestinalis. She underwent intestinal resection for gangrenous small bowel. A multidisciplinary approach with aggressive medical and surgical management may improve survival. Our case and the literature confirm the high morbidity of patients with calciphylaxis and vascular complications. Careful follow-up remains necessary for diagnosis and management to prevent complication, infection, and death.