• Title/Summary/Keyword: Compartment syndromes

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Experience with the emergency vascular repair of upper limb arterial transection with concurrent acute compartment syndrome: two case reports

  • Charles Chidiebele Maduba;Ugochukwu Uzodimma Nnadozie;Victor Ifeanyichukwu Modekwe
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.60-64
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    • 2023
  • Upper extremity vascular injuries occurring with acute compartment syndrome are very challenging to manage in an emergency context in resource-poor settings. The need to always recognize the likelihood of coexisting compartment syndrome guides surgeons to perform concomitant fasciotomy to ensure a better outcome. We managed three vascular injuries in the upper extremities in two patients with concomitant imminent compartment syndrome observed intraoperatively. The first injury was complete brachial artery disruption following blunt trauma, while the second and third injuries were radial and ulnar artery transection caused by sharp glass cuts. Both patients were treated with vascular repair and fasciotomy. Secondary wound coverage was applied with split-thickness skin grafting, and the outcomes were satisfactory. Concomitant fasciotomy potentially improves the outcomes of vascular repair in emergency vascular surgery and should be considered for all injuries with the potential for acute compartment syndrome.

Fasciotomy in compartment syndrome from snakebite

  • Kim, Yong Hun;Choi, Jin-hee;Kim, Jiye;Chung, Yoon Kyu
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.69-74
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    • 2019
  • Background Local symptoms and signs of snake envenomation mimic the clinical features of compartment syndrome. It is important to measure the intracompartmental pressure to diagnose compartment syndrome. In this study, we present our experiences of confirming compartment syndrome and performing fasciotomy in snakebite patients based on high intracompartmental pressure findings. Methods The medical records of patients who visited the trauma center of Wonju Severance Christian Hospital from January 2010 to December 2015 for the management of venomous snakebite were retrospectively reviewed. Starting in 2014, fasciotomy was performed in patients with an intracompartmental pressure of more than 40 mmHg in addition to the clinical symptoms of compartment syndrome. Results A total of 158 patients with snakebite came to the hospital within 48 hours for treatment. Most patients (110 patients) were bitten at the upper extremities (69.6%). Since 2014, 33 out of 59 patients were suspected to have compartment syndrome, and their intracompartmental pressures were measured. Seventeen of those patients had a high intracompartmental pressure (average, 49.6 mmHg; range, 37-88 mmHg), and fasciotomy was performed. Conclusions In this study, as many as 10.8% of all cases were in need of fasciotomy when compartment syndrome was diagnosed by measuring the intracompartmental pressure. Previously, it was reported that fasciotomy was not required in many cases of compartment syndrome originating from snakebite. However, some patients may develop very severe compartment syndrome, requiring fasciotomy.

Phlegmasia Cerulea Dolens after Coronary Artery Bypass Surgery: What Should We Know

  • Lee, Kang-Hoon;Park, Hyun-Suk;Yie, Kilsoo
    • Journal of Chest Surgery
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    • v.47 no.1
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    • pp.43-46
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    • 2014
  • Phlegmasia cerulea dolens (PCD) is one of the most critical disorders of acute deep vein thrombosis in that it can cause permanent disability secondary to the compartment syndrome. Although several etiological factors have been proposed, PCD after coronary artery bypass surgery is extremely rare and its definitive pathophysiology is still under debate. We herein present a case of PCD that resulted in the compartment syndrome after coronary artery bypass surgery. Early recognition and decompression of PCD are crucial for saving the affected limbs.

Comparison between Surgical and Conservative Treatments in Isolated Lateral Compartment Syndrome of the Lower Leg: A Case Report (하지 외측 구획에 국한된 구획 증후군에서 수술적 치료와 보존적 치료 간에 비교: 증례 보고)

  • Gwak, Heui-Chul;Seo, Young-Chae;Jung, Soo-Hwan;Kim, Dae-Yoo
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.3
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    • pp.136-142
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    • 2022
  • Lateral compartment syndrome of the lower leg is rarely observed. Hence, there may be difficulty in diagnosis as its clinical patterns are different and more complicated than usual. We report two rare cases of a 20-year-old and a 28-year-old diagnosed with isolated lateral compartment syndrome who had either a surgical or conservative treatment. The comparison was done by analyzing the progression of neurological manifestation, electromyography, and nerve conduction study for two years. In the final follow-up, the patient who underwent the surgical treatment showed a shorter recovery time. However, both patients showed a full recovery from neurologic deficits.

Compartment syndrome due to extravasation of peripheral parenteral nutrition: extravasation injury of parenteral nutrition

  • Park, Huee Jin;Kim, Kyung Hoon;Lee, Hyuk Jin;Jeong, Eui Cheol;Kim, Kee Won;Suh, Dong In
    • Clinical and Experimental Pediatrics
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    • v.58 no.11
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    • pp.454-458
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    • 2015
  • Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain adequate nutrition via the oral route. However, there is an inherent risk of extravasation, which can cause compartment syndrome, especially when detected at a later stage. Herein, we report a rare case of compartment syndrome and skin necrosis due to extravasation, requiring emergency fasciotomy and skin graft in a 7-month-old boy who was treated with peripheral parenteral nutrition via a pressurized infusion pump. Although we cannot estimate the exact time at which extravasation occurred, the extent and degree of the wound suggest that the ischemic insult was prolonged, lasting for several hours. Pediatric clinicians and medical teams should carefully examine the site of insertion of the intravenous catheter, especially in patients receiving parenteral nutrition via a peripheral intravenous catheter with a pressurized infusion pump.

Intra-abdominal hypertension during hip arthroscopy: a case report

  • Saeyoung Kim;Hyun-Su Ri;Ji Hyun Kim;iyong Yeom
    • Journal of Yeungnam Medical Science
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    • v.40 no.1
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    • pp.102-105
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    • 2023
  • Symptomatic extravasation of irrigation fluid is a rare complication of hip arthroscopy. However, depending on the amount of fluid, intra-abdominal hypertension (IAH) may occur and even develop into abdominal compartment syndrome, which can seriously alter hemodynamic circulation. Therefore, it is important for anesthesiologists to promptly recognize the abnormal signs of IAH for early diagnosis and better clinical outcomes. Nevertheless, these signs are difficult to detect because they are usually obscured when the patient is under anesthesia and masked by surgical drapes. We report a case of IAH under general anesthesia during hip arthroscopy to highlight possible symptoms and signs.

Acute Compartment Syndrome Induced by Rhabdomyolysis Due to Antipsychotic Drug Overuse (항정신병 약물 과량 복용 후 발생한 횡문근융해증으로 인한 급성 구획증후군)

  • Hwang, Seok-Ha;Hong, Sung-Ha;Suh, Seung-Pyo;Kim, Joo-Young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.276-280
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    • 2020
  • A 49-year-old male was found unconscious at his accommodation and visited the emergency room. He was on antipsychotic and antidepressant drugs (vortioxetine hydrobromide, mirtazapine, sertraline hydrochloride, quetiapine, and alprazolam) for schizophrenia and major depression. At the time of discovery there were signs of overdose of the drugs around the patient. A physical examination revealed, pain, pallor, and edema in the left buttocks and lateral thigh. Active ankle movements below the left ankle were not possible and sensations in the tibia and peroneal nerves were lost. The pressure in the buttock compartment was measured at 42 mmHg. Magnetic resonance imaging revealed edema and high intensity signals in the left hip muscles and surrounding soft tissue. An emergency fasciotomy was performed and partial restoration of the lower extremity sensation and muscle strength were achieved after 24 hours.

A Case of Chronic Renal Failure Associated with Systemic Capillary Leak Syndrome (전신성 모세혈관 누출 증후군으로 인한 만성 신질환 1예)

  • Baek, Seon Ha;Shin, Nara;Kim, Hyo Jin;Han, Mi Yeun;Choi, Dong-Ju;Bang, Soo-Mee;Kim, Sejoong;Paik, Jin Ho
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.145-149
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    • 2012
  • Systemic capillary leak syndrome (SCLS) is an unusual entity characterized by hypovolemic shock, hemoconcentration, and hypo-albuminemia associated with paraproteinemia as a result of marked capillary hyper-permeability. Complications of this syndrome can include compartment syndromes, pulmonary edema, thrombosis, and acute kidney injury. This paper reports a case of severe SCLS accompanied by acute tubular necrosis caused by hypoperfusion and myoglobinuria secondary to rhabdomyolysis, which resulted in chronic kidney disease that necessitated hemodialysis. However, there have been rare data of residual end-organ damage after acute attacks in Korea. Therefore, this paper reports a case of complicated SCLS enough to hemodialysis and that developed into chronic kidney disease.

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Thromboembolectomy in Acute Arterial Occlusion (급성 동맥폐색증에서 혈전색전 제거술 -48례 경험-)

  • 김진희
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.792-797
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    • 2000
  • Background : Even though there were developments in various treatment techniques for acute arterial occlusion this disease still has high rate of mortalities and limb amputations. We investigated the combined diseases symptoms location of occlusion type of treatment complication and prognosis in our patients. Meterial and methods: This study recruited 48 patients(42 men, 6 women, mean age 57.7 years) who received the operation from January 1995 toDecember 1998. We investigated the post-operation course via medical record review or telephone interview with patients or their family members. Result: The most common combined diseases were atherosclerosis in 30 patients. other diseases were 17 diabetes mellitus 16 hypertension and 12 atrial firillation. Pain and clod sensation were noticed in all patients paresthesia in 5 patients fibrillation. Pain and cold sensation were noticed in all patients paresthesia in 5 patients and lower extremity paralysis in 11 patients. In 29 patients the time interval from the onset of symptom to admission was over 72 hours and 15 patients were admitted within 24 hours. The distribution of arterial occlusion location was at 28 femoral arteries 14 popliteal arteries and 6 iliac arteries. All the patients were received embolectomy and 5 patients were received additional bypass grafting. Postoperative complications were 12 reocclusions. 6 compartment syndromes 6 skin necrosis and 2 acute renal failure. The mortality rate was 16.7%(8/48) and the amputation rate was 25% Conclusion : This study revealed 25% reocclusion 25% limb amputation and 16.7% mortaliyt. To improve the prognosis of acute lower extrements arterial occlusion early diagnosis and understand the underlying diseases prompt treatment and operation additional operation including interventional radiologic examination and thorough postoperative care would be appreciated.

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