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

Mohanty, Chitta Ranjan; Sahoo, Alok Kumar; Panda, Ritesh; Jain, Mantu

doi:10.4103/joacp.joacp_146_18

Cited by 4 publications

(5 citation statements)

References 5 publications

(9 reference statements)

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“… BMI: body mass index; AAA: abdominal aortic aneurysm; BMI: body mass index; EVAR: endovascular aneurysm repair; NR: not reported. References: Benevides & Nochi Júnior (2006); Cameron-Gagné et al (2018); Chew et al (2009); Hau et al (2016); Keene et al (2010); Kumar et al (2007); Matta & Kelley (2014); Mohanty et al (2019); O’Leary et al (2010); Oates et al (2016); Osteen & Haque (2012); Pereira & Heath (2015); Polacek et al (2009); Pua et al (2005); Reisiger et al (2005); Rudolph et al (2011); Sarwar & Ting (2017); Somayaji et al (2005); Ting et al (2015); Viviani et al (2016). …”

Section: Discussionmentioning

confidence: 99%

“…CS is often described in the context of a fracture or vascular injury, and occurs in a distal extremity (Shore et al 2013). Gluteal compartment syndrome (GCS) is one of the rarest types of CS (Smith et al 2012) and cases have been described following prolonged immobilisation secondary to substance abuse (Kuhlman & Gwathmey 2018, Mustafa et al 2009), post-traumatic, after orthopaedic surgery, bone biopsy and intramuscular infection (Kumar et al 2007, Mohanty et al 2019, Osteen & Haque 2012, Polacek et al 2009, Somayaji et al 2005). Early identification and treatment of this condition are essential as the patient is at risk of developing irreversible sequelae, such as rhabdomyolysis, renal failure, multiorgan failure and even death (Mustafa et al 2009).…”

Section: Introductionmentioning

confidence: 99%

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‘A pain in the buttock’: A case report of gluteal compartment syndrome after robotic partial nephrectomy

Yang

Anidjar

Azzam

2022

Journal of Perioperative Practice

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Acute compartment syndrome is a surgical emergency that, if unrecognised, leads to tissue and muscle ischaemia, necrosis, multi-organ failure and even death. Gluteal compartment syndrome is a rare type of compartment syndrome that typically occurs as a sequela of trauma, and its presentation may be difficult to recognise. We describe a case of a patient who developed gluteal compartment syndrome following a prolonged renal surgery in lateral decubitus position. Our case report aims to raise clinicians’ awareness to consideration of this rare syndrome in patients presenting with lower extremity or back pain after prolonged surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

‘A pain in the buttock’: A case report of gluteal compartment syndrome after robotic partial nephrectomy

Yang

Anidjar

Azzam

2022

Journal of Perioperative Practice

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“…Table 1 shows the details of the included papers/ cases. All studies were retrospective case reports [ 6 , 10 – 17 ]. The average age was 53.2 years old, with most cases (84.6%) being males and the average BMI was 33.7 (from the studies that recorded BMI).…”

Section: Discussionmentioning

confidence: 99%

“…Clinical diagnosis. Fasciotomy 47 h post-op Weak hip abductors with positive Trendelenburg sign and residual limp when walking at 18 months post-op but complete recovery of the sciatic nerve Mohanty, 2019 [ 17 ] : Gluteal compartment syndrome a rare complication of lithotomy position and continuous postoperative analgesia 27yo M BMI 36 PMH: obesity R PCL repair - 2 h 30 min Combined spinal-epidural Modified Lithotomy position Ipsilateral No severe pain in the right buttock whilst there was a recovery of sensory block. On examination, we noticed a tense, tender swelling in the right buttock.…”

Section: Discussionmentioning

confidence: 99%

“…Nine patients in our review had epidural anesthesia used for the operation and/or postoperatively. It has been mentioned in the literature that epidural analgesia may predispose susceptible patients to gluteal compartment syndrome [ 12 , 17 ]. In our case, the patient underwent the surgery under general anesthesia that why he had a severe pain shortly postoperative, this may support the use of general anesthesia in certain surgical interventions, which have the high risk of the position related compartment syndrome.…”

Section: Discussionmentioning

confidence: 99%

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Missed positional gluteal compartment syndrome in an obese patient after foot surgery: a case report

et al. 2020

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Background Gluteal compartment syndrome is an uncommon condition and can be difficult to diagnose. It has been diagnosed after trauma, vascular injury, infection, surgical positioning, and prolonged immobilization from drug or alcohol intoxication. The diagnosis is based on clinical findings and, in most cases, recognizing these symptoms and making a diagnosis early is critical to a complete recovery. Case presentation A 53-year-old male who underwent left foot surgery had severe pain to his contralateral hip and posterior gluteal compartment radiating to the right lower extremity immediately postoperative. He was positioned supine with a “bump” placed under his right hip to externally rotate his operative leg during the surgery. Due to the patient’s complex past medical history, a presumptive diagnosis of a herniated disc and/or compression of the sciatic nerve was made as a cause for the patient’s pain. This resulted in a misdiagnosis period of 36 h until the patient was diagnosed with unilateral gluteal compartment syndrome. Performing a fasciotomy was decided against due to the increased risk of complications. The patient was treated with administration of IV fluids and closely monitored. On post-op day 6, the patient was discharged. At three months post-op, the patient was walking without a limp and he had no changes in his peripheral neurologic examination compared to his preoperative baseline. Conclusion Gluteal compartment syndrome is a surgical emergency that must be considered postoperatively especially in obese patients with prolonged operation times who experience acute buttock pain. The use of positional bars or “bumps” in the gluteal area should be used with caution and raise awareness of this complication after orthopedic surgeries.

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Should Regional Anesthesia Be Used for Orthopedic Trauma Patients?

Lee¹,

Elkassabany²

2023

Evidence-Based Practice of Anesthesiology

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

Cited by 4 publications

References 5 publications

‘A pain in the buttock’: A case report of gluteal compartment syndrome after robotic partial nephrectomy

‘A pain in the buttock’: A case report of gluteal compartment syndrome after robotic partial nephrectomy

Missed positional gluteal compartment syndrome in an obese patient after foot surgery: a case report

Should Regional Anesthesia Be Used for Orthopedic Trauma Patients?

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