Experiences with PGE1 in Patients with Phlegmasia Coerulea Dolens and in Ergotism

  • J. D. Gruss


The use of prostaglandin E1 (PGE1) was investigated in eight patients who were all emergencies, in that their life and limb were in peril. Four patients had phlegmasia coerulea dolens with, despite thrombectomy and fasciotomy, rapidly advancing venous gangrene. Three lower limbs and one upper limb were involved. Continuous, high-dosed, intra-arterial PGE1 treatment saved the three lower limbs. The fate of the upper limb was still in the balance when the patient died of a fulminating pulmonary embolism. Four patients were suffering from ergotism in the wake of multiple trauma and long-term thrombosis prophylaxis with a combined dihydroergotamine-heparin preparation. All the patients were referred to our hospital at a late stage and after many other types of treatment had been tried. Here again, three lower limbs and one upper limb were involved. The combined regimen of continuous intra-arterial and intermittent intravenous PGE1 retained the function of one lower limb and one upper limb. Knee exarticulation in one young woman and below-knee amputation in another young woman were unavoidable. The treatments lasted between 8 and 12 days. The intra-arterial dosage was 0.25 ng/kg · min and the intravenous dosage was 320 µg/day.


Superficial Femoral Artery Ergot Alkaloid Multiple Trauma Doppler Probe Lumbar Sympathectomy 
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  1. 1.
    Bollinger A (1970) Periphere Zirkulation. In: Siegenthaler W (ed) Klinische Pathophysiologie Thieme, Stuttgart, p 563Google Scholar
  2. 2.
    Creutzig A, Kamin K, Flöge J, Wannske M, Alexander K, Wagner HH (1985) Ergotamin-induzierte periphere Durchblutungsstörungen — ein Fallbericht. Röntgenblätter 38: 193PubMedGoogle Scholar
  3. 3.
    Gruss JD, Vargas-Montano H, Bartels D, Simmenroth HW, Sakurai T, Schäfer G, Fietze-Fischer B (1984) Use of prostaglandins in arterial occlusive diseases. Int Angiology 3 [Suppl]: 7Google Scholar
  4. 4.
    Levy JM, Ibrahim F, Nykamp PW, Weiland DE (1984) Prostaglandin E1 for alleviating symptoms of ergot intoxication: a case report. Cardiovasc Intervent Radiol 7: 28PubMedCrossRefGoogle Scholar
  5. 5.
    Loewenthal J, May J (1985) Phlegmasia coerulea dolens. Br J Surg 52: 584CrossRefGoogle Scholar
  6. 6.
    Sutton D, Preston BJ (1970) Angiography in peripheral ischaemia due to ergotism. Report of two cases. Br J Radiol 43:776PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1986

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  • J. D. Gruss

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