Garrett Alexandrea L, Weber Lauren V, Bhatt Amar M
Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.
College of Pharmacy, The Ohio State University, Columbus, OH, USA.
J Med Cases. 2023 Apr;14(4):137-140. doi: 10.14740/jmc4100. Epub 2023 Apr 30.
Tongue ischemia is a devastatingly rare disease complication that is typically attributed to cranial arteritis, vasculitis, or prolonged oral intubation that manifests in a patient as a phenotypically black or discolored tongue. There have been less than 10 cases reported in the literature, however, documenting tongue ischemia secondary to shock states requiring high-dose vasopressor support. In these cases, the ischemia or necrosis has typically been limited to the tip of the tongue or has been associated with unilateral disease as bilateral tongue involvement is unlikely given the collateral blood supply of the tongue. To date, the use of imaging modalities to confirm lingual artery disease as the etiology for the presentation of tongue ischemia has been limited. We present a unique case of bilateral tongue ischemia following the use of cardiopulmonary bypass which was confirmed with radiographic evidence demonstrating bilateral lingual artery disease. The nature of case is presented, previous reports of similar cases are reviewed, and potential etiologies of this rare manifestation are discussed.
舌缺血是一种极其罕见的疾病并发症，通常归因于颅动脉炎、血管炎或长时间口腔插管，患者表现为舌头发黑或变色。文献报道的病例不足10例，然而，记录因休克状态继发舌缺血且需要高剂量血管升压药支持的病例更少。在这些病例中，缺血或坏死通常局限于舌尖，或与单侧病变相关，因为鉴于舌的侧支血供，双侧舌受累不太可能。迄今为止，使用影像学手段来确认舌动脉疾病是舌缺血表现的病因的情况有限。我们报告了一例在体外循环后出现双侧舌缺血的独特病例，影像学证据证实存在双侧舌动脉疾病。本文介绍了该病例的情况，回顾了既往类似病例的报道，并讨论了这种罕见表现的潜在病因。
