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Gangrene

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Gangrene is one of the forms of necrosis of tissues, when the whole limb or part of it, as well as the organ or its part, is affected by necrotic process, for example: gangrene of foot, limb, lung, gut, gall bladder, appendix, etc.

trusted-source [1], [2], [3], [4], [5], [6], [7], [8]

What causes gangrene?

At the heart of gangrene are vascular disorders, primarily, arterial blood flow. With a rapid violation of blood circulation, the destructive process proceeds almost instantaneously. This happens with thrombosis, ruptures, arterial infringements (rarely veins, for example, vein thrombosis of the mesentery, upper vena cava), when exposed to microflora, for example, anaerobic.

In the parenchymal organs, the process of necrosis of the tissue site has a peculiar character, which has been defined as a heart attack: heart, lungs, liver, spleen, kidneys. In uncomplicated cases, the infarction zones are lysed with resorption and replacement by scar tissue or encapsulate them (the capsules are mostly fibrous). But with infarctions at any time in case of infection, inflammation can develop (for example, in the lung: infarct-pneumonia or abscess in case of encapsulation of the infarction, and in case of attachment of putrefactive microflora gangrene may develop). The necrosis of areas of the brain was called "stroke", which under favorable conditions undergoes softening and lysis without the formation of scarring: The gangrene of the brain is not due to the rapid death of the patient.

In the case of a slow development of circulatory disorders - with obliterating diseases, angiotrophoneuroses, vasculitis, diabetic angiopathy - the prenecrotic phase is prolonged, accompanied first by tissue atrophy, and then development of gangrene with blood flow decompensation. One of the forms of gangrene of the skin and subcutaneous tissue are bedsores that arise because of prolonged compression of tissues in the forced position and disturbance of microcirculation in them.

How is gangrene manifested?

Gangrene in the clinical course is divided into dry, wet, anaerobic (gas).

Dry gangrene, as a rule, is superficial or captures small distal segments of the limb segment, for example, one or more fingers. Has a brown or black color, the demarcation line is well defined, surrounding tissues, although atrophic, but has no signs of inflammation. There is no general reaction of the body to the process, only manifestations of the underlying and accompanying diseases.

Wet gangrene of extremities and internal organs is accompanied by a rapid spread of edema and hyperemia, involvement of the lymphatic system, rapid destruction of tissues, increasing total intoxication of the body. Sites of dry necrosis can persist, but around them "swelling and hyperemia of the tissues. A special place is occupied by gas gangrene