Ischemic necrosis of the tongue in a patient following vasopressor agents use and prolonged endotracheal intubation: A case report

Ischemic necrosis of the tongue is rare condition due to its rich vascular supply. No cases have been reported in Korea to date. A 55-year-old male with a history of dyslipidemia and fatty liver presented with abdominal pain and vomiting. Despite fluid resuscitation, he developed severe hypotension, requiring vasopressor support and mechanical ventilation. During his intensive care unit stay, the patient exhibited signs of disseminated intravascular coagulation, with progressive skin necrosis and thrombocytopenia. Upon extubation, oral examination revealed widespread mucosal discoloration and blood clots, and ischemic necrosis on dorsal surface of the tongue was confirmed. This case highlights the potential risk of tongue ischemia as a rare but serious complication of multifactorial cause including prolonged vasopressor use and endotracheal intubation. Further studies are needed to better understand its pathophysiology and improve management strategies.