Well leg compartment syndrome after surgery for ulcerative colitis in the lithotomy position: A case report

Enomoto, Tsuyoshi; Ohara, Yusuke; Yamamoto, Masayoshi; Oda, Tatsuya; Ohkohchi, Nobuhiro

doi:10.1016/j.ijscr.2016.04.006

Cited by 11 publications

(17 citation statements)

References 13 publications

(16 reference statements)

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“… 2 , 4 , 5 The possibilities are: arterial hypoperfusion due to the leg being above the level of the heart; venous obstruction from kinking of the veins at the groin or due to external pressure from the stirrups or intermittent compression cuffs; and an increase in compartment pressure resulting from the weight of the limb in the stirrups or passive plantar flexion of the foot. 3 , 5 - 7 …”

Section: Discussionmentioning

confidence: 99%

“…Rapid recognition and prompt intervention are paramount to alleviate this complication and avoid additional damage such as sensory deficits, paralysis, possible limb amputation, and potential multiple organ insufficiency secondary to compartment syndrome. 3 , 10 , 11 …”

Section: Discussionmentioning

confidence: 99%

“…However, the sensitivity of individual findings for identification of compartment syndrome is low (13-19%). 2 , 3 , 11 , 12 Observation of additional clinical findings can increase the chances of accurately identifying compartment syndrome, as high as 93% with the addition of a third symptom. 3 Thus, although definitive diagnosis can only be made based on direct measurement of intra-compartmental pressure, clinicians should be acutely aware of the potential for compartment syndrome if one or more of the above symptoms are identified in patients following surgery in the lithotomy position.…”

Section: Discussionmentioning

confidence: 99%

“…It occurs when intra-compartmental pressure increases within non-expandable fascia, leading to interstitial edema and increased compartmental pressure, decreasing perfusion of the muscles. 1 - 3 Untreated, it may cause serious complications that can lead to permanent neurological damage, motor dysfunction, acute renal failure, amputations, metabolic acidosis, infections, sepsis, and death. 2 …”

Section: Introductionmentioning

confidence: 99%

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Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

et al. 2019

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Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

et al. 2019

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“…We present a rare case of bilateral lower extremity acute compartment syndrome that developed in a healthy 23-year-old female after undergoing a laparoscopic salpingectomy for ruptured ectopic pregnancy in the usual lithotomy position. This case highlights a rare complication that has been previously associated with lithotomy or hemilithotomy positioning [ 2 , 5 , 12 , 13 ]. Lower extremity ACS is a pathologic condition in which increased tissue pressure within a closed osseofascial space compromises blood circulation and normal function of tissues within the compartment leading to tissue hypoxia and necrosis [ 8 , 14 ].…”

Section: Case Presentationmentioning

confidence: 99%

The dangers of lithotomy positioning in the operating room: case report of bilateral lower extremity compartment syndrome after a 90-minutes surgical procedure

et al. 2016

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BackgroundLower extremity acute compartment syndrome after gynecologic surgery in the lithotomy position is a rare, yet potentially devastating complication. A high level of suspicion is paramount for early recognition and mitigation of acute compartment syndrome originating from prolonged surgery in lithotomy position.Case presentationA 23-year-old female, gravida 1, para 0, underwent a laparoscopic salpingectomy for a ruptured ectopic pregnancy. Surgical time was 90 min. Postoperatively, the patient developed acute compartment syndrome of both legs necessitating emergent bilateral four-compartment fasciotomies, with repeated returns to the operating room for 2nd look procedures and delayed wound closures. The patient regained full function within 3 months and returned to an unrestricted baseline activity level.ConclusionTechnical diligence in applying a lithotomy position is paramount for preventing postoperative lower extremity compartment syndrome. A high level of suspicion for this severe complication in conjunction with early recognition and immediate surgical management can mitigate long-term adverse sequelae and improve postoperative outcomes.

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Preventing well leg compartment syndrome among patients in the lithotomy position—Operating room nurses' perspectives: A qualitative study

Susanne,

Åsa

2023

Nursing Open

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AimTo describe operating room nurses' experiences of well leg compartment syndrome and how they work perioperative to prevent it during the lithotomy position.DesignThe study had a qualitative design.MethodsFocus group interviews were performed with 10 operating room (OR) nurses. The interviews were semi‐structured and analysed by qualitative content analysis. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ).ResultsThe main theme showed that the OR nurses shoulder duty and responsibility, independently and in the team, but they need more structural support and knowledge. The themes showed that they follow routines whenever possible and take responsibility for positioning; however, they have to balance between flexibility and strict routines. Although they also develop and participate in teamwork, they still need further knowledge.ConclusionThe severe complication of well leg compartment syndrome (WLCS) can occur when the patient is in the lithotomy position. Maintaining the same routines and paying attention to the WHO's surgical safety checklist were described as actions that could prevent well leg compartment syndrome.Patient or Public ContributionNo patient or public contribution. We have interviewed nurses but without financial support since the study was performed and supervised within a master programme.

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Well leg compartment syndrome after surgery for ulcerative colitis in the lithotomy position: A case report

Cited by 11 publications

References 13 publications

Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

The dangers of lithotomy positioning in the operating room: case report of bilateral lower extremity compartment syndrome after a 90-minutes surgical procedure

Preventing well leg compartment syndrome among patients in the lithotomy position—Operating room nurses' perspectives: A qualitative study

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