Rationale: Symmetrical peripheral gangrene (SPG) is a rare and life-threatening condition characterized by symmetrical distal ischemic damage that can progress to gangrene at 2 or more anatomical sites, without involvement of a large vessel obstruction or vasculitis. We report the case of an older adult female who developed septic shock and disseminated intravascular coagulation (DIC) postoperatively, complicated by the onset of SPG. Patient concerns: A 66-year-old female was transferred to the intensive care unit for postoperative management. She subsequently developed septic shock and DIC. On the 10th day of admission, acral necrosis was observed in both feet. Diagnoses: Septic shock complicated by DIC and SPG. Interventions: Upon intensive care unit admission, the patient received ongoing organ support and anti-infection therapy. Phentolamine was applied via wet compresses to both feet. Outcomes: Due to anastomotic leakage and multiple organ failure, the patient’s family chose to discharge her from the hospital. Lessons: In cases of SPG, prevention is more important than treatment. Early correction of underlying conditions and identification of risk factors can improve patient outcomes.
Zhu et al. (Fri,) studied this question.