Gluteal Compartment Research Articles

Комплексное лечение флегмоны ягодичной области и компартмент-синдрома

Комплексное лечение флегмоны ягодичной области и компартмент-синдрома

Gluteal compartment syndrome a rare complication of lithotomy position and continuous postoperative epidural analgesia.

Gluteal compartment syndrome a rare complication of lithotomy position and continuous postoperative epidural analgesia.

Delayed Presentation of Gluteal Compartment Syndrome due to Pseudoaneurysm Rupture

We present a 26-year-old active duty man who sustained a coccygeal fracture and gluteus maximus hematoma after a fall from height during training. The patient returned 3 weeks postinjury with symptoms and physical examination findings concerning for gluteal compartment syndrome. An expanding gluteal hematoma was confirmed on imaging and the patient was taken to the operating room for emergent evacuation and endovascular hemostasis. This case of gluteal compartment syndrome is a unique contribution to the literature with respect to the specific vascular injury observed and the delayed presentation of gluteal compartment syndrome.

Not Just Another “Found Down”: Concomitant Upper Arm and Gluteal Compartment Syndrome

BackgroundCompartment syndrome is often considered in patients with long-bone fractures and soft-tissue injuries, but is not as commonly associated with a period of unconsciousness. Case ReportA 65-year-old man was brought to our emergency department (ED) because he had lost consciousness for an unknown amount of time after snorting heroin. He had severe pain in his upper right arm. Physical examination revealed right arm edema, paresthesia, tenderness, and firmness to palpation. During the ED assessment, the patient began to experience pain in his right hip to a degree exceeding examination findings. We considered compartment syndrome affecting his upper arm as well as his gluteal muscles. The patient was taken to the operating room for fasciotomy. The triceps muscle was found to be bulging out of the compartment, demonstrating advanced compartment syndrome. A posterior approach to the hip allowed the gluteal sling and the fascia to be released, eliminating tension on the gluteus medius/minimus and gluteus maximus compartments. With physical therapy, the patient regained full flexion and extension in his arm at the elbow, partial extension of his wrist, and range of motion and strength in his hip. Why Should an Emergency Physician Be Aware of This?If not recognized, compartment syndrome can jeopardize limb and life. It should be considered in patients experiencing inordinate pain, especially if they were found unconscious at the incident scene. Pressure-induced ischemia can impair muscle function within hours. If it is not relieved with fasciotomy, the patient can sustain irreversible functional loss.

Dynamic contrast-enhanced MRI perfusion of normal muscle in adult hips: Variation of permeability and semi-quantitative parameters

The purpose of this prospective study was to ascertain the degree of variation of semi-quantitative and permeability parameters on DCE-MRI of normally appearing striated muscles. Dynamic contrast-enhanced MRI of the right hip was performed in 20 women and 24 men. Mean age was 39.1 ± 12.4 years. Two regions of interest (ROI) were drawn in twelve muscles of anterior, medial and gluteal compartments: a free-form ROI covering the largest muscle section and a smaller elliptical ROI. Semi-quantitative and permeability parameters were calculated using the extended Tofts model. Statistical analysis was performed with a linear mixed model to assess perfusion parameters variation. Intra- and inter-observer agreements were assessed.The intra-observer agreement was considered to be good for free-form ROI (minimum Intra-Class Coefficient (ICC) = 0.72) and moderate for elliptical ROI (minimum ICC = 0.51), while the inter-observer agreement was considered to be bad in both cases (minimum ICC = 0.11). There was a high inter-individual variation in most of the perfusion parameters evaluated. The average coefficients of variation were: Time To Peak = 9%, Area Under the Curve = 44%, Ve = 61%, Kep = 90%, Initial Slope = 99%, and Ktrans = 128%. A considerable variation in resting muscle perfusion parameters was seen. This could lead to errors in the analysis of muscle DCE-MRI studies or oncologic/non oncologic studies using muscle as a referential. Further studies targeted on acquisition protocols and post-processing software are necessary to improve the performance of muscle MR perfusion.

Buttocks Hard as Rocks: Not Wanted after Aortic Dissection Repair

The authors report the case of a patient developing a gluteal compartment syndrome after DeBakey type I dissection repair. Prompt recognition and treatment led to successful results. The surgical approach to the gluteal compartment is described.

Postoperative gluteal compartment syndrome following microsurgical free-flap hand reconstruction: the importance of early recognition and treatment

Compartment syndrome, a surgical emergency, is caused by an increase in pressure within a closed osseofascial space, often due to trauma. This causes a decrease in tissue perfusion and ultimately...

Gluteal Compartment Syndrome with Neurologic Impairment: Report of Two Cases and Review of the Literature (P6.124)

Gluteal Compartment Syndrome with Neurologic Impairment: Report of Two Cases and Review of the Literature (P6.124)

Gluteal compartment syndrome with neurologic impairment: Report of 2 cases and review of the literature

We describe two patients who developed gluteal compartment syndrome (GCS) in the context of drug overdose. One patient developed a sciatic neuropathy, and one patient developed a lumbosacral plexopathy. We reviewed the literature of atraumatic GCS and resultant neurological impairment. We reviewed 26 cases (our two cases and 24 previously published cases) of GCS and neurological impairment. All patients developed GCS in the context of drug or alcohol overdose. Creatine kinase was markedly elevated in all patients in which it was tested, and most patients developed renal failure. Seventeen patients had a fasciotomy, and 9 patients were managed conservatively. There appeared to be a trend toward worse prognosis in the conservatively managed group. Neurologists should be aware of GCS. Immediate recognition facilitates consideration of further diagnostic testing, including intracompartmental pressure measurement and consideration of surgical decompression, which may influence outcome. Muscle Nerve, 57: 325-330, 2018.

Gluteal compartment syndrome and delayed hemorrhage of superior gluteal artery following an old pelvic fracture: a case report

Gluteal compartment syndrome and delayed hemorrhage of superior gluteal artery following an old pelvic fracture: a case report

Gluteal compartment syndrome caused by traumatic rupture of the superior gluteal artery

<p>Introduction. We report a case of a sixty-year-old man diagnosed with glutealcompartment syndrome caused by traumatic rupture of the superior glutealartery associated with fracture of the inferior pubic ramus and blunt trauma.Case report. A patient was injured falling from a height of four meters. Signsof compartment syndrome and sciatic nerve compression developed threehours after the injury. The patient went through a computerized tomography(CT) scan procedure with contrast, which showed a hematoma in the glutealregion, but without signs of active bleeding. However, after observation andmonitoring of the patient, CT angiography was performed which revealeda rupture of the superior gluteal artery. Fasciotomy and debridement wereperformed and the patient was diagnosed with gluteal compartment syndromeand rupture of the superior gluteal artery. Surgery resulted in a significantimprovement of the patient’s condition.Conclusion. Traumatic gluteal compartment syndrome is a rare condition.Gluteal compartment syndrome should be taken into consideration in eachpatient with pelvic trauma and hematoma in the gluteal region whose neurologicalstatus is affected. Prompt diagnosis and fasciotomy are crucial inthe treatment and fasciotomy presents the gold standard in the treatment.</p>

Secondary extremity compartment syndrome after traumatic cardiac arrest

The objective of this case report is to investigate the pathophysiology, diagnosis, and surgical management of secondary extremity compartment syndrome. This case-based review documents the development of secondary extremity compartment syndrome in the setting of high-volume fluid resuscitation for a hemorrhagic cardiac arrest complicated by a global ischemia-reperfusion injury. A 21-year-old male presented with traumatic, hemorrhagic cardiac arrest. Following a resuscitative thoracotomy, massive transfusion and return of spontaneous circulation, the patient underwent damage control surgery. Over the first 48 h following the injury, the patient developed progressive diffuse interstitial edema ultimately culminating in compartment syndrome of the remaining three uninjured extremities as well as both uninjured gluteal compartments. The patient underwent bilateral lower extremity, thigh, gluteal, and right upper extremity compartment fasciotomies, with the left lower extremity being the single, traumatically injured extremity. To our knowledge, this is the only case of secondary extremity compartment syndrome in which bilateral gluteal compartments and bilateral thigh compartments were involved in addition to the bilateral upper and right lower extremities. The goal of this case report is to examine the pathophysiology of the development of secondary extremity compartment syndrome, with an emphasis on early recognition and surgical intervention.

Bariyatrik Cerrahinin Gözden Kaçan Komplikasyonu: Gluteal Kompartman Sendromu

Gluteal compartment syndrome (GCS) is an uncommon non-traumatic rhabdomyolysis induced by staying in the same position for a long time during a surgical operation or under the effect of drugs. In bariatric surgery, overweight patients are more prone to this syndrome. If a patient has complaints such as hip or leg pain, sciatic nerve palsy and red-brown colored urine in the post-op period, GCS should be taken into consideration. For patients having a long operation time due to technical problems, the creatinine kinase level should be controlled and the gluteal region should be examined carefully. The treatment options of GCS include early aggressive fluid replacement, alkalinization of urine with sodium bicarbonate, surgical decompression and debridement. Here we present a case of a 40-year-old obese patient who underwent bariatric surgery resulting in GCS, renal failure, and death.

Gluteal Compartment Syndrome Secondary to Traumatic Rupture of Gluteus Maximus

Gluteal Compartment Syndrome Secondary to Traumatic Rupture of Gluteus Maximus

Gluteal Compartment Syndrome Secondary to Traumatic Rupture of Gluteus Maximus

Gluteal Compartment Syndrome Secondary to Traumatic Rupture of Gluteus Maximus

Gluteal Compartment Syndrome Secondary to Pelvic Trauma.

Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

Delayed Presentation of Gluteal Compartment Syndrome: The Argument for Fasciotomy.

A male patient in his fifties presented to his local hospital with numbness and weakness of the right leg which left him unable to mobilise. He reported injecting heroin the previous morning. Following an initial diagnosis of acute limb ischaemia the patient was transferred to a tertiary centre where Computed Tomography Angiography was reported as normal. Detailed neurological examination revealed weakness in hip flexion and extension (1/5 on the Medical Research Council scale) with complete paralysis of muscle groups distal to this. Sensation to pinprick and light touch was globally reduced. Blood tests revealed acute kidney injury with raised creatinine kinase and the patient was treated for rhabdomyolysis. Orthopaedic referral was made the following day and a diagnosis of gluteal compartment syndrome (GCS) was made. Emergency fasciotomy was performed 56 hours after the onset of symptoms. There was immediate neurological improvement following decompression and the patient was rehabilitated with complete nerve recovery and function at eight-week follow-up. This is the first documented case of full functional recovery following a delayed presentation of GCS with sciatic nerve palsy. We discuss the arguments for and against fasciotomy in cases of compartment syndrome with significant delay in presentation or diagnosis.

Bilateral post-traumatic gluteal compartment syndrome: A case report and review of literature

Gluteal compartment is a rare site for compartment syndrome. Gluteal compartment syndrome has most commonly been described in the literature as occurring after prolonged immobility associated with substance abuse, improper operative positioning, sickle cell-induced infarct, post-traumatic and spontaneous superior gluteal artery rupture, exercise, and post-arterial embolization of the internal iliac artery prior to abdominal aortic aneurysm repair. Trauma is rarely associated with this syndrome. Gluteal compartment syndrome occurs in approximately 0.9% of trauma patients. Posttraumatic gluteal compartment syndrome develops because of edema with traumatic contusions, crush injuries and hematoma formation due to blunt superior or inferior gluteal artery injuries in all compartments of the gluteal region Only 6 previous cases have been reported in the literature. Two previous cases involved positioning for urological procedures, while the other cited causes of bilateral gluteal compartment syndrome include exercise-induced, trauma, and prolonged immobilization from substance abuse. One of the most immediately devastating results of a missed compartment syndrome is the risk of the development of rhabdomyolysis with the resulting squeal of myoglobinuria, hyperkalemia, and acidosis resulting in renal failure, shock, multiple organ failure, disseminated intravascular coagulation, and possibly death. Here we report a case of posttraumatic bilateral compartment syndrome which developed secondary to pressure due to patient being trapped under a vehicle following a vehicular accident. He was operated upon and a bilateral fasciotomy was done. Although he did not develop any renal complications, the sciatic nerve palsy on the left side did not recover. The patient is still under follow up.

Bilateral gluteal and lower limbs compartment syndrome: a case report

Bilateral gluteal and lower limbs compartment syndrome: a case report

Early Experience in Da Vinci Robot-Assisted Partial Nephrectomy: An Australian Single Centre Series.

Introduction and Objectives. To demonstrate the safety and efficacy of the robot-assisted partial nephrectomy (RAPN) technique in an Australian setting. Methods. Between November 2010 and July 2014, a total of 76 patients underwent 77 RAPN procedures using the Da Vinci Surgical System© at our institution. 58 of these procedures were performed primarily by the senior author (PB) and are described in this case series. Results. Median operative time was 4 hours (range 1.5–6) and median warm ischaemic time (WIT) was 8 minutes (range 0–30) including 11 cases with zero ischaemic time. All surgical margins were clear with the exception of one patient who had egress of intravascular microscopic tumour outside the capsule to the point of the resection margin. Complications were identified in 9 patients (15.8%). Major complications included conversion to open surgery due to significant venous bleeding (n = 1), reperfusion injury (n = 1), gluteal compartment syndrome (n = 1), DVT/PE (n = 1), and readmission for haematuria (n = 1). Conclusion. This series demonstrates the safety and efficacy of the RAPN technique in an Australian setting when performed by experienced laparoscopic surgeons in a dedicated high volume robotic centre.