Oedema and Cyanosis of the Hand Following Injections Into a Vein on the Dorsum of the Hand

Abstract

A case is described in which cyanosis and oedema of the hand and wrist followed injections into a vein on the dorsum of the hand. This was treated with intra-arterial procaine and block of the stellate ganglion. Possible causes for this reaction are venous spasm followed by thrombosis, leakage, reflex arterial and venous spasm and histamine release.

Acute Reversible Hand Ischemia after Clindamycin injection

“…According to Walker et al the increased capillary permeability may be aggravated by the biotoxins that accumulate at the site of the occlusion because of acute limb ischemia. 5 Research by Ellertson et al also supports the view that the venospasm and associated thrombosis lead to outflow obstruction, followed by cyanosis, transudation, edema, and finally arterial stasis which lead to ischemic necrosis 6 In a case reported by Webster et al 7 similar dramatic cyanosis and swelling of the hand as in our case was observed after an injections given in the veins on the dorsum of the hand. The reporter suggested the possibility ofa venous spasm, followed by venous thrombosis as the cause of the vascular changes.…”