Acute Hand Frostbite Induced by Liquefied Petroleum Gas Exposure: A Case Report

Abstract

Introduction Liquefied petroleum gas is colorless, odorless hydrocarbon mixture. Rapid evaporation cause cold injury, as the resulting drop in temperature can lead to frostbite [1]. Frostbite represents a cold induced injury in which tissue temperatures fall low enough to allow ice crystal formation within superficial deep layers [2]. For frostbite injuries, initiating reperfusion directed therapy early is associated with superior tissue protection compared with conventional conservative care, defined as noninvasive management without active restoration of microvascular flow [3]. Case Presentation This case describes a 34 y.o. man who sustained a right hand injury while refueling a car with LPG. Immediately after the incident, his hand became numb and cold. Examination showed diffuse redness, swelling, and hypoesthesia. He was admitted to the ICU for thrombolysis. After treatment swelling stabilized and a single serous blister appeared dorsally, the dorsal hand and medial side of the fifth finger were paler, but all fingers remained warm. Further management included LMWH aspirin ibuprofen and wound care with paraffin mesh and sterile dressings. Early antithrombotic therapy and local wound care preserved perfusion, halted injury progression and resulted in complete hand viability. At discharge swelling and sensory deficits had resolved, skin integrity was restored and no ischemic changes were present. Discussion When exposed to cold, the body responds by alternating vasoconstriction and vasodilation to protect the extremities from cold induced damage [4]. However this protective response can also lead to severe injury, including progressive thrombosis and tissue ischemia [5]. Early thrombolytic therapy has been shown to reduce amputation rates in severe frostbite [6]. In our case, early assessment and prompt medical reperfusion therapy stabilized perfusion and improved tissue recovery. Conclusions This unique case highlights the potential severity of LPG induced frostbite and the importance of early recognition of frostbite as a thrombotic injury. Prompt vascular assessment and monitoring of tissue perfusion guided targeted treatment. Early thrombolytic and antithrombotic therapy improved perfusion halted injury progression and resulted in complete preservation of hand viability with full functional recovery.