Case Of Bilateral Compartment Syndrome Research Articles

Bilateral Atraumatic Compartment Syndrome of the Legs Leading to Rhabdomyolysis and Acute Renal Failure Following Prolonged Kneeling in a Heroin Addict. A Case Report and Review of Relevant Literature

ABSTRACT Introduction Compartment syndrome is defined as a symptom complex caused by increased pressure of tissue fluid in a closed osseofascial compartment which interferes with circulation to the myoneural components of the compartment. Bilateral compartment syndrome of the legs is a rare presentation requiring emergent surgical intervention. In a recent case report (Khan et al 2012) there have been only eight reported cases cited with bilateral compartment syndrome. Heroin abuse is known to cause compartment syndrome, traumatic and atraumatic rhabdomyolysis. Hypothyroidism can also independently present with rhabdomyolysis. Case presentation We present a case of a 22 years old female who presented with bilateral swelling of the legs with associated loss of sensation having spent two days kneeling against the wall following IV heroin abuse. She presented to the emergency department with bilateral swelling of the legs with loss of sensation. She was diagnosed with compartment syndrome requiring emergent bilateral 4 compartment fasciotomy of the lower extremities. Inspite of aggressive fluid resuscitation she developed rhabdomyolysis complicated by acute renal failure requiring dialysis. She made a full recovery with full return of her renal as well as motor and sensory function. Conclusion We discuss this interesting case of bilateral compartment syndrome in a heroin abusive patient with history of hypothyroidism complicated by rhabdomyolysis and acute renal failure. There have been isolated case reports of bilateral compartment syndrome following prolonged surgery. High index of suspicion, early recognition and therapeutic intervention is the key to good outcome. We discuss the etiopathology and management options of rhabdomyolysis. Treating the comorbities like hypothyroidism is also important for the recovery. How to cite this article Biswas S, Rao RS, Duckworth A, Kothuru R, Flores L, Abrol S. Bilateral Atraumatic Compartment Syndrome of the Legs Leading to Rhabdomyolysis and Acute Renal Failure Following Prolonged Kneeling in a Heroin Addict. A Case Report and Review of Relevant Literature. J Trauma Critical Care Emerg Surg 2013;2(3):139-145.

Bilateral Leg Compartment Syndrome Complicating Prolonged Spine Surgery in the Kneeling Position

A case of bilateral compartment syndrome of the legs complicating prolonged spine surgery in the kneeling-90-90 position. Aggressive treatment of the reperfusion injury prevented severe rhabdomyolysis, acute renal failure, and sepsis, although it could not avoid the permanently disabling muscular necrosis. Close postoperative surveillance facilitate an early diagnosis and expedite appropriate treatment.

Syndrome de compression des loges bilatéral des membres inférieurs et myonécrose sévère due à l’usage inapproprié de la simvastatine

Bilateral leg compartment syndrome due to myonecrosis caused by inappropriate use of statins is a rare but potentially fatal complication of this lipid lowering medication. We report a case of a 39-year-old woman who presented with suspicious critical lower limb ischemia. Subsequently, bilateral leg compartment syndrome and myonecrosis developed. The primary cause of myonecrosis was due to misuse of simvastatin mistaken by the patient for a weight-reducing drug. Urgent fasciotomies were performed and the patient underwent urgent renal replacement therapy with continuous hemodialysis for acute renal failure due to myoglobinuria. After this complex treatment, the patient was discharged. She almost fully recovered with only a residual paresis of the left fibular nerve. According to literature, this is a unique case of bilateral compartment syndrome and myonecrosis with acute renal failure due to statin overdose leading to acute renal failure and bilateral fasciotomy.

Bilateral Compartment Syndrome Complicating Prolonged Lithotomy Position

A case of bilateral compartment syndrome after prolonged Lloyd-Davies lithotomy position is described. The diagnosis was made early, despite effective extradural bupivacaine-fentanyl analgesia. The aetiology, diagnosis, pathology and treatment of compartment syndrome are described. Complications of the syndrome may be life-threatening and permanently disabling. The anaesthetist should be aware of the potential complications of the operative positions of the unconscious patient.