Two cases of unidentified acute compartment syndrome

Acute compartment syndrome (ACS) is a surgical emergency that requires urgent fasciotomy to prevent irreversible sequelae. We report two cases of unidentified ACS, which did not result from traumatic injuries such as fractures or crush injury, iatrogenic injury or diseases such as haematological mal...

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Bibliographic Details
Published in:BMJ case reports 2018-04, Vol.2018, p.bcr-2017-222377
Main Authors: Takeda, Shinsuke, Tatebe, Masahiro, Sakai, Atsushi, Hirata, Hitoshi
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Animals
Arm Injuries - etiology
Arm Injuries - pathology
Arm Injuries - surgery
Case reports
Compartment syndrome
Compartment Syndromes - diagnosis
Compartment Syndromes - etiology
Compartment Syndromes - surgery
Dehydrogenases
Edema
Fasciotomy
Gangrene
Hemodialysis
Hospitals
Humans
Intensive care
Japan
Laboratories
Leg Injuries - etiology
Leg Injuries - pathology
Leg Injuries - surgery
Male
Medical diagnosis
Pain
Snake Bites - complications
Trauma
Treatment Outcome
Unusual Presentation of More Common Disease/Injury
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Summary:Acute compartment syndrome (ACS) is a surgical emergency that requires urgent fasciotomy to prevent irreversible sequelae. We report two cases of unidentified ACS, which did not result from traumatic injuries such as fractures or crush injury, iatrogenic injury or diseases such as haematological malignancies. Both patients complained of severe pain and swelling of their extremity. No bite marks, blisters or skin necrosis was noted. They also complained of marked symptoms of third cranial nerve injury, including divergent squint and diplopia. The diagnosis of ACS was made following continuous intracompartmental pressure measurement, and both patients underwent urgent fasciotomy with partial incision. Considering the season and location of the injuries, together with the rapid progression of signs and symptoms that included thrombocytopaenia, acute renal failure, rhabdomyolysis and especially that of third cranial nerve injury, we postulate that these two cases may have developed following mamushi (Gloydiusblomhoffii) bites.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2017-222377