[Acute ischemia of the hand in a drug addict after accidental intra-arterial injection].
We report a case of a 31-year-old male drug addict with acute ischaemia of the right hand after inadverted intraarterial injection of suspended tablets into brachial artery. He was successfully treated with intraarterial administration of urokinase (250'000 IU as bolus, then continuous infusion of 250'000 IU per 12 hours), papaverin (40 mg i.v. 3 x every 4 hours), systematic heparinisation and with axillary plexus anesthesia (Bupivacain 0.25%, 10 ml/h). Treatment options are discussed reviewing recent publications. Early onset of treatment is mandatory for a good outcome.
Bittner
Ch
Ch
Chirurgische Klinik, Departement Chirurgie, Kantonsspital Olten.
Zuber
M
M
Eisner
L
L
D000328:Adult; D002045:Bupivacaine; D003161:Compartment Syndromes / Q000139:chemically induced / Q000601:surgery; D000071938:Fasciotomy; D006225:Hand / Q000098:blood supply*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D007269:Injections, Intra-Arterial / Q000009:adverse effects*; D007511:Ischemia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D009407:Nerve Block; D010208:Papaverine / Q000008:administration & dosage; D015819:Substance Abuse, Intravenous / Q000150:complications*; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D013287:Illicit Drugs; D006493:Heparin; D010208:Papaverine; D014568:Urokinase-Type Plasminogen Activator; D002045:Bupivacaine