Cases reported "Compartment Syndromes"

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1/56. Compartment syndrome after simple venipuncture in an anticoagulated patient.

    An excessively anticoagulated 52-year-old man on chronic warfarin therapy developed a forearm compartment syndrome after venipuncture in an antecubital vein. At fasciotomy, active venous bleeding into the forearm from the venipuncture site was noted, and a large forearm hematoma was evacuated. Anticoagulated patients or those with coagulopathies are at risk for compartment syndrome after percutaneous needle punctures and should be warned of this possibility. Such individuals should be instructed to seek immediate medical attention if any signs or symptoms of this complication occur.
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ranking = 1
keywords = vein
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2/56. A tale of two syndromes: ovarian hyperstimulation and abdominal compartment.

    Abdominal compartment syndrome complicated severe ovarian hyperstimulation in a 35 year old woman with multiple bowel resections due to Crohn's disease. pain from ovarian enlargement necessitated hospital admission. Despite intravenous fluid administration and heparin prophylaxis, ilio-femoral deep vein thrombosis developed. Treatment by intravenous heparin was complicated by repeated intra-ovarian bleeding, anaemia and acute renal failure requiring haemodialysis. Intra-abdominal pressures were elevated. After placement of an inferior vena caval filter and discontinuation of heparin, there was slow spontaneous recovery without surgery.
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ranking = 282.37521424907
keywords = deep vein thrombosis, deep vein, thrombosis, vein thrombosis, deep, vein
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3/56. Phlegmasia cerulea dolens with compartment syndrome: a complication of femoral vein catheterization.

    OBJECTIVE: Central venous catheterization is commonly performed in the critically ill. The femoral vein is widely accepted as an insertion site with complications thought to be comparable to other central access sites. We used serial ultrasound examinations with Doppler to examine the evolution of a heretofore undescribed complication of femoral vein catheterization, phlegmasia cerulea dolens with compartment syndrome. DESIGN: Serial ultrasounds were performed in patients before the insertion of femoral venous catheters and sequentially every 48 hrs while the catheters were in place. The noncatheterized leg served as a control. SETTING: A trauma and life support center of a tertiary multidisciplinary critical care unit. PATIENT: A 32-yr-old man with respiratory failure as a consequence of a severe community-acquired pneumonia that required central venous access for antibiotics because no peripheral sites could be obtained. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The initial ultrasound examination of both legs before femoral catheter insertion revealed no sign of venous thrombosis. Ultrasound of the catheterized leg at 48 hrs revealed a small nonocclusive thrombosis, whereas the opposite leg remained normal. At 72 hrs, the catheterized leg had clinical and ultrasonographic evidence of a massive thrombosis. A compartment syndrome defined by pressure measurements soon ensued and required emergent surgical release. CONCLUSIONS: This case report and a review of the available literature suggest that thrombosis associated with femoral vein catheterization should be considered when clinicians decide where to obtain central venous access when multiple sites are available. This report also suggests the utility of serial ultrasound examinations to define clinically nonapparent thrombosis as an early indicator of a potentially catastrophic complication.
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ranking = 164.16343537357
keywords = thrombosis, venous thrombosis, vein
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4/56. Ectopic calcification following tibial fracture: property analysis.

    We present a patient whose ectopic calcification following deep posterior compartment syndrome was studied by electron microscopy, chemical analyses, and x-ray diffraction. The patient complained of a toe flexion deformity following a tibial fracture which he sustained 18 years earlier. Damage to the peroneal artery was demonstrated by magnetic resonance angiography, suggesting that the patient had had deep posterior compartment syndrome in the past. A large radiopaque mass, identified in the flexor hallucis longus muscle by radiographs and computed tomography, was resected, resulting in a dramatic improvement of the toe deformity. The resected material was analyzed in detail. It included no osseous tissue, and was not birefringent under a polarizing microscope, being compatible with ectopic calcification rather than ossification. On electron microscopy the material was found to be an assembly of tiny rods. Chemical and x-ray diffraction analyses suggested a carbonate-containing apatite as the most probable substance.
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ranking = 4.04399677604
keywords = deep
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5/56. Haemoglobin SC disease presenting with a compartment syndrome secondary to a deep vein thrombosis.

    A patient presented with a deep vein thrombosis (DVT), which resulted in a compartment syndrome of both the thigh and the calf. Subsequently, the patient was found to have haemoglobin SC disease. Prompt fasciotomies were performed; however, some muscle and nerve damage was later clinically apparent. This case highlights the value of prompt diagnosis of compartment syndrome and the need for urgent formal fasciotomies. The case also demonstrates the value of seeking an underlying cause for a DVT when none is apparent.
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ranking = 1411.8760712454
keywords = deep vein thrombosis, deep vein, thrombosis, vein thrombosis, deep, vein
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6/56. Compartment syndrome after Bosworth fracture-dislocation of the ankle: a case report.

    There are only a few reported cases of compartment syndrome after an ankle fracture, and all have involved the deep posterior compartment. We present a case in which a patient had a Bosworth fracture-dislocation of the ankle, underwent open reduction internal fixation, and subsequently had an anterior compartment syndrome of the leg. Early recognition and prompt treatment are essential to avoid the late sequelae of compartment syndrome.
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ranking = 2.02199838802
keywords = deep
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7/56. lower extremity compartment syndrome in an adolescent with spinal cord injury.

    OBJECTIVE: Describe the unusual complication of lower extremity compartment syndrome occurring in an adolescent with spinal cord injury (SCI). methods: Case presentation. RESULTS: A 17-year-old male with C5 asia A complete SCI developed a compartment syndrome of his lower leg on the ninth day postinjury. Presenting signs included an equinus deformity of the foot, blackened induration over the anterior tibia, circumferential erythematous markings over the calf, large urticarial lesions over the knee, and calf swelling. The presumed etiology of the compartment syndrome was excessive pressure from elastic wraps, which were placed over gradient elastic stockings. Pressures were 51 mmHg in the superficial posterior, 50 mmHg in the deep posterior, 33 mmHg in the anterior, and 34 mmHg in the peroneal compartments. The patient also developed rhabdomyolysis with myoglobinuria. In addition to supportive care, the patient underwent a dual incision fasciotomy for compartment release. CONCLUSIONS: The development of lower extremity compartment syndrome was probably a result of excessive pressure applied by elastic wraps. Elastic wraps should be used with caution in individuals with SCI.
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ranking = 2.02199838802
keywords = deep
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8/56. Aortic thrombosis after low anterior resection for rectal cancer: report of a case.

    Pelvic surgery for malignant disease has been associated with numerous acute postoperative complications. These complications are primarily vascular or neurologic in origin. Several factors associated with the occurrence of these complications include the lithotomy position, the prolonged use of sequential compression devices, the use of certain types of stirrups, the presence of peripheral vascular disease, and the common hypercoagulable state of most cancer patients. We report for the first time a case of aortic thrombosis after elective low anterior resection for rectal cancer and discuss some factors that may have a role in the occurrence of this devastating complication.
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ranking = 145.6317887086
keywords = thrombosis
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9/56. lower extremity compartment syndrome after coronary artery bypass.

    Compartment syndrome is a rare and dangerous complication of coronary artery bypass. All reported cases involved the vein donor limb. Once recognized, immediate fasciotomy is necessary to prevent irreversible ischemia and limb loss. diagnosis requires a high index of suspicion and close observation of the patient, particularly those remaining intubated during the early postoperative period.
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ranking = 1
keywords = vein
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10/56. thigh compartment syndrome after acute ischemia.

    thigh compartment syndrome (TCS) is a poorly recognized clinical condition that may follow reperfusion of acutely ischemic thigh muscles. The anterior muscle group appears to be at greatest risk because of its layered arrangement. Intense pain, swelling, and elevated compartment pressures characterize the early presentation in the affected muscle group. If untreated myonecrosis, myoglobinuria, and renal failure may result. TCS was observed in a patient who was treated for a gunshot wound to the left thigh. The superficial femoral and profunda femoris veins as well as the profunda femoris artery were disrupted. The superficial femoral vein and profunda femoris artery injuries were repaired but the mangled branches of the profunda femoris vein were ligated. Postoperatively he developed intense thigh pain, swelling, and elevated compartment pressures. Lateral thigh fasciotomy, extensive debridement of necrotic muscle, and delayed wound closure resulted in a full recovery. physicians should recognize the numerous clinical circumstances that could lead to TCS--particularly those associated with trauma or physical activity. Timely recognition and intervention may be both limb and life saving. Associated irreparable injury to the profunda femoris vein may aggravate this condition.
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ranking = 4
keywords = vein
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