Non-traumatic compartment syndrome secondary to deep vein thrombosis and anticoagulation

Abstract

We describe an unusual case of non-traumatic compartment syndrome in three compartments of the left lower limb in a 57-year-old male inpatient. He had recently been started on anticoagulation therapy for multiple pulmonary emboli and deep vein thrombosis of the left posterior tibial and peroneal veins. Three of the four osteofascial compartments had pressures above 70 mm Hg, hence four compartment fasciotomies were performed. Postoperatively, intravenous heparin therapy was started resulting in a significant blood loss, but he had no neurovascular deficit. At reoperation, for primary wound closure, his tissues looked healthy. Non-traumatic causes of acute compartment syndrome, including deep venous thrombosis and anticoagulation, are considered.

Phlegmasia Alba Dolens Complicating Rhabdomyolysis

“…Additional laboratory results of elevated urea, creatinine, and creatine kinase (CK) in PAD raised suspicion of rhabdomyolysis related to compartment syndrome and acute kidney injury (AKI). These conditions were considered as secondary impact, but important to recognize [ 10 ]. Rhabdomyolysis is characterized by the triad of muscle weakness, myalgias, and dark urine.…”

“…Fasciotomy and surgical decompression are performed to overcome compartment syndrome, to prevent further muscle necrosis [ 16 ]. Endovascular intervention with catheter-directed thrombolysis is usually an effective therapy for the extensive DVT such as in PAD and PCD [ 10 , 17 ]. In rarer cases, mechanical thrombolysis using aspiration thrombectomy devices or balloon angioplasty can be performed.…”

Lower limb (healthy leg) compartment syndrome after the patient was in the lithotomy position during the operation: a case study

“…Osteofascial compartment syndrome requires prompt diagnosis and treatment to prevent irreversible neuromuscular damage, ischemic contracture, rhabdomyolysis, acute kidney injury, infection, and death [5]. The treatment requires urgent fasciotomy to relieve the symptoms of ischemia and hypoxia and prevent irreversible sequelae [6].…”

Idiopathic Acute Compartment Syndrome of the Leg with Incidental Deep Venous Thrombosis: A Case Report

“…This is especially true in atraumatic cases, in which making a diagnosis of ACS may be more difficult [4, 5]. Common causes of atraumatic compartment syndromes have been reported including prolonged immobilization during surgery [6], insect and snake envenomation [7], hypothyroidism [8], long-standing uncontrolled diabetes [9, 10], occlusive acute deep vein thrombosis, use of anticoagulant therapy [11-13], and repetitive chronic trauma [14]. Our patient had no history of trauma and no recent history suggestive of any of the above possible etiologies leading to a delay in diagnosis.…”