Abstract
BackgroundAcute compartment syndrome is a limb-threatening and occasionally life-threatening emergency that is rarely reported as a complication following childbirth. Prompt diagnosis is crucial to avoid permanent functional restriction or even the loss of the affected limb. Clinical signs and symptoms might be nonspecific, especially in the early stages; therefore, knowledge of predisposing risk factors and signs and symptoms of acute compartment syndrome is necessary to prevent long-term complications and amputation.Case presentationThis paper presents a case of a 26-year-old primiparous Sri Lankan woman who developed acute compartment syndrome of the lower right limb following childbirth by cesarean section.ConclusionAcute compartment syndrome is an important differential diagnosis in the setting of sudden onset of lower limb pain following childbirth. Predisposing factors for its manifestation within an obstetric environment are augmented labor, the lithotomy position, postpartum hemorrhage, hypotension following epidural analgesia, and the use of vasoconstrictive agents. If left undiagnosed and untreated, acute compartment syndrome may cause permanent neurovascular deficit, leading to a poor functional result, tissue ischemia, limb amputation, and rhabdomyolysis. If severe, and in large compartments, it can lead to renal failure and death. Alertness and a high index of clinical suspicion for the possibility of acute compartment syndrome are required to avoid a delay in diagnosis, and intracompartmental pressure measurement can be used to confirm the diagnosis.
Highlights
Acute compartment syndrome is a limb-threatening and occasionally life-threatening emergency that is rarely reported as a complication following childbirth
Alertness and a high index of clinical suspicion for the possibility of acute compartment syndrome are required to avoid a delay in diagnosis, and intracompartmental pressure measurement can be used to confirm the diagnosis
Other factors that have been associated with Acute compartment syndrome (ACS) include ischemia-reperfusion injury; hemorrhage; phlegmasia cerulea dolens; vascular puncture in patients with bleeding disorders; intravenous/arterial drug injection; and soft tissue injury resulting from prolonged limb compression due to lithotomy positioning during surgery, constricting casts or wraps, crush injury, or burns [2, 3]
Summary
Acute compartment syndrome is a limb-threatening and occasionally life-threatening emergency that is rarely reported as a complication following childbirth. Case presentation: This paper presents a case of a 26-year-old primiparous Sri Lankan woman who developed acute compartment syndrome of the lower right limb following childbirth by cesarean section. ACS of the limb is a limb-threatening and occasionally life-threatening emergency. It is caused by an increased intracompartmental pressure (ICP) that causes a Coulton et al Journal of Medical Case Reports (2020) 14:140 decrease in perfusion pressure, leading to hypoxemia of the tissues [2]. A decrease in tissue perfusion can lead to irreversible necrosis, which may result in functional impairment, loss of limb, and, in rare cases, death [2]. ACS has been associated with nephrotic syndrome, rhabdomyolysis, bleeding disorders, iatrogenic factors, and infections such as Streptococcus spp. [2]
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