Gluteal Compartment Syndrome After Prolonged Immobilization in Drug Abusers

Abstract

Background There has been an increasing incidence of drug abuse patients presenting with rhabdomyolysis after prolonged immobilization. Our study was to assess etiology and management challenges with patients presenting with gluteal compartment syndrome after drug abuse. Methodology We did a retrospective analysis of five patients who presented with gluteal compartment syndrome secondary to drug abuse over one year. Results We had a 100% association with rhabdomyolysis and acute renal injury necessitating hemodialysis. There was a frequent association with the involvement of additional compartments like thigh and leg. Conclusion Patients with drug overdose can present with unusual compartment syndrome involvement like the gluteal compartment. Compartment syndrome is a surgical emergency and needs multidisciplinary involvement.

Gluteal compartment syndrome secondary to prolonged immobilization following carbon monoxide poisoning associated with leukoencephalopathy: A case report

“…Atraumatic gluteal compartment syndrome (GCS) is rare occurrence, it is hypothesized that prolonged pressure due to resting on hard uneven surfaces in an unusual position can lead to gluteal muscles swelling and edema, resulting in increased intra-compartmental pressure [ 22 ]. This can occur in multiple conditions where the patient consciousness or orientation has been altered, such as drug abuse, alcohol intoxication, carbon monoxide poisoning, and surgical positioning [ 10 , [15] , [16] , [17] , [18] , 23 ]. Due to the large muscle mass GCS is frequently accompanied by crush syndrome, which describes systemic manifestations of rhabdomyolysis and multiple organ failure alongside compartment syndrome [ 3 , 11 , 12 , 14 , 24 , 25 ].…”

“…Gluteal compartment syndrome (GCS) is a rare diagnosis and results mostly from a non-traumatic case such as prolonged surgery, substance abuse, or drug overdose [ [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] ]. Carbon monoxide poisoning as a cause of gluteal compartment syndrome is rarely reported in the literature [ 17 , 18 ].…”