Intraoperative Point of Care Ultrasound Facilitates Diagnosis and Evacuation of Encapsulated Hematoma

Abstract

The presented image was a 6 x 6 cm encapsulated hematoma deep to the gastrocnemius muscle with the surgeon’s finger as a reference for size (Figure 1 A/B). The surgery team had a high index of suspicion that an encapsulated hematoma was present in a coagulopathic patient who had previously underwent four-compartment fasciotomy, but despite excellent exposure from the fasciotomy incisions, the team was unable to locate the hematoma. The hematoma was revealed by the anesthesiologist using Point of Care Ultrasound (PoCUS) with a linear probe (13-6 MHz, HFL38, Edge-II ®, SonoSite), which was sterilely draped into the surgical field. After localizing the hematoma, a suction catheter was inserted and a total of 250 mL was drained (Figure 1C).