Supplementary Material for: Four Limb Amputation Secondary to Symmetrical Peripheral Gangrene in a Polytrauma Patient: A Case Report

Symmetrical peripheral gangrene (SPG) is a rare condition. At present, there is no clear etiology for this condition; however, it has been associated with multiple risk factors, including sepsis and coagulopathy. We present a patient who sustained a polytrauma with multiple organ injuries. During hospitalization, he developed septic and cardiogenic shock complications by disseminated intravascular coagulopathy, which led to ischemic changes in all four limbs. The patient underwent bilateral – trans-tibial and trans-radial – amputation. High level of suspicion and awareness are required to detect such a devastating condition in order to mitigate complications. We conclude that ischemic changes secondary to SPG are irreversible; subsequently, halting the disease progression is the mainstay of treatment.