Rhabdomyolysis recognized after elevation of liver enzymes following prolonged urologic surgery with lateral decubitus position -A case report-

Lee, Guie Yong; Lee, Heeseung; Kim, Youn Jin

doi:10.4097/kjae.2011.61.4.341

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…According to another study, the serum peak AST level was correlated with the peak CK, and the serial test result during admission showed a similar pattern between both enzymes. 2,4 These findings suggest that an elevated AST level in rhabdomyolysis might be a marker of skeletal muscle injury instead of hepatocyte damage. In the present study, serum peak AST elevation was approximately five times the upper limit of normal, and the peak ALT elevation was more than two times the upper limit of normal, which concurs with a previous study.…”

Section: Discussionmentioning

confidence: 91%

Serum Aminotransferase Level in Rhabdomyolysis according to Concurrent Liver Disease

Heo

Park

et al. 2019

Korean J Gastroenterol

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Background/Aims: The serum aminotransferase level is usually elevated in rhabdomyolysis, and these enzymes originate from the skeletal muscle. On the other hand, there is limited data showing whether the degree of elevation of these enzymes differs according to the concurrent liver disease. Methods: Patients with rhabdomyolysis were selected when their serum creatinine kinase level was >1,000 U/L. They were categorized as the group with and without concurrent liver disease. The AST and ALT levels in both groups were compared. In addition, the aminotransferase level was compared between those with rhabdomyolysis and those with alcoholic liver disease. Results: Among the 165 patients with rhabdomyolysis, 19 had concurrent liver disease. The median peak AST was higher in the group with concurrent liver disease (332 U/L [interquartile range (IQR), 127-1,604] vs. 219 U/L [IQR,). In addition, the median peak ALT was higher in the group with concurrent liver disease (107 U/L [IQR, 74-418] vs. 101 U/L [IQR,). On the other hand, there was no significant difference in both enzymes between the two groups. The median peak AST level was significantly higher in those with rhabdomyolysis than in those with alcoholic liver disease (221 U/L [IQR, vs. 103 U/L [IQR,), but the median peak ALT was not significantly different (102 U/L [IQR, vs. 51 U/L [IQR,). Conclusions: Rhabdomyolysis showed an elevated AST-dominant aminotransferase level, which is not different according to concurrent liver disease. Therefore, it is recommended that rhabdomyolysis be considered first in cases of elevated aminotransferase levels in patients with a suspicious skeletal muscle injury.

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Section: Discussionmentioning

confidence: 91%

Serum Aminotransferase Level in Rhabdomyolysis according to Concurrent Liver Disease

Heo

Park

et al. 2019

Korean J Gastroenterol

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“…Surgical positions that can cause rhabdomyolysis include the lateral decubitus and lithotomy, as well as sitting, knee-to-chest, and prone positions [ 7 ]. In urologic surgery, there are few cases of rhabdomyolysis after surgery [ 8 , 9 ]. The flank position is used in nephroureterectomy because it offers better accessibility.…”

Section: Discussionmentioning

confidence: 99%

Gluteal Compartment Syndrome and Rhabdomyolysis after Prolonged Laparoscopic Nephroureterectomy and Treatment Strategies Including Rehabilitation: A Case Report

et al. 2021

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Background: Rhabdomyolysis is a clinical symptom caused by the rapid release of intracellular components such as myoglobin, lactate dehydrogenase, and creatine kinase into the blood circulation. It is commonly caused by muscular injury including compartment syndrome, infection, drugs, etc. Although it rarely occurs during surgery, the incidence may increase if risk factors such as long operation time, improper posture, and condition of being overweight exist. Case Presentation: A 46-year-old male patient complained of pain and weakness in the right hip area and several abnormal findings were observed in the blood sample, reflecting muscle injury and decreased renal function after prolonged urological surgery. He was confirmed as having rhabdomyolysis, which was caused by compartment syndrome of the right gluteal muscle. After the diagnosis, conservative cares were performed in the acute phase and rehabilitation treatments were performed in the chronic phase. After conservative treatment and rehabilitation, blood sample values returned to almost normal ranges and both level of pain and muscle strength were significantly improved. In addition, about 25 days after discharge, he almost recovered to pre-operative condition. Conclusion: Careful attention is required to prevent intraoperative compartment syndrome. It also suggests that not only medical treatment but also early patient-specific rehabilitation is important in patients with rhabdomyolysis after prolonged surgery.

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“…High CK concentrations suggest the presence and damage of myocytes in a proper way 21 . CK is slowly and totally degraded and removed from circulation, so concentrations in serum remain elevated much longer than myoglobin concentration in urine.…”

Section: Discussionmentioning

confidence: 99%

Causes of rhabdomyolysis in acute poisonings

Jankovic

Jovic-Stosic

Vučinić

et al. 2013

VSP

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RM syndrome occurs at a relatively high rate in acute poisonings. Although agent's toxicity is crucial for the outcome, severe RM and its complications may significantly influence the clinical course and prognosis of poisoning. Routine analysis of CK, as a relevant marker for RM may indicate the development of RM in acute poisoning and initiate prompt therapeutic measures in preventing acute renal failure as the most frequent consequence of extensive rhabdomyolysis.

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Rhabdomyolysis recognized after elevation of liver enzymes following prolonged urologic surgery with lateral decubitus position -A case report-

Cited by 8 publications

References 13 publications

Serum Aminotransferase Level in Rhabdomyolysis according to Concurrent Liver Disease

Serum Aminotransferase Level in Rhabdomyolysis according to Concurrent Liver Disease

Gluteal Compartment Syndrome and Rhabdomyolysis after Prolonged Laparoscopic Nephroureterectomy and Treatment Strategies Including Rehabilitation: A Case Report

Causes of rhabdomyolysis in acute poisonings

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