Cases reported "Compartment Syndromes"

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1/95. Lower limb compartment syndrome resulting from malignant hyperthermia.

    We report a case of compartment syndrome complicating malignant hyperthermia (MH) in a previously healthy patient. An intraoperative MH crisis responded to treatment with intravenous dantrolene. The patient subsequently developed a lower limb compartment syndrome which required fasciotomy. Recognition of the link between MH and compartment syndrome helps ensure prompt diagnosis and treatment of this rare complication of MH.
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2/95. Compartment pressure monitoring during anterior cruciate ligament reconstruction.

    A prospective double blind randomized study was carried out using 20 healthy males with anterior cruciate ligament (ACL) insufficiency undergoing bone-patellar tendon-bone ACL reconstruction. The subjects were randomized into either water or saline irrigation and then underwent identical reconstructive procedures using an arthroscopic pump. Continuous preoperative, intraoperative, and postoperative pressures were monitored using the slit catheter technique. blood pressure and compartment pressure measurements were continuously recorded and noted at all stages of the procedure. Mean preoperative anterior and posterior compartment pressures were similar in both groups. No significant differences were noted between the anterior and posterior compartments of each group. No difference between water and saline irrigation was identified throughout the procedure. In both groups, postoperative pressures were slightly lower in the anterior and posterior compartments compared with preoperative pressures, but not significantly.
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3/95. Abdominal compartment syndrome in patients with burns.

    Abdominal compartment syndrome (ACS) is a well-recognized perioperative complication that occurs in patients who undergo intra-abdominal operations and who require extensive fluid resuscitation. The classic presentation of this syndrome includes high peak airway pressures; oliguria, despite adequate filling pressures; and intra-abdominal pressures of more than 25 mm Hg. A decompressive laparotomy performed at the bedside can alleviate ACS. If left untreated, sustained intra-abdominal hypertension is often fatal. In the literature, ACS has been described in pediatric patients with burns but not in adult patients with burns. This article describes 3 adults who sustained burns of more than 70% of their body surface areas, who required more than 20 L of crystalloid resuscitation, and who developed ACS during their resuscitation after the burn injury. The mortality rate among these patients was 100%, which confirms the grave consequences of this syndrome. In our institution, intra-abdominal pressure is now routinely measured as part of the burn resuscitation process in an attempt to diagnose and treat this syndrome earlier and more efficaciously. It is recommended that the possibility of ACS be considered when diagnosing any patient with burns who develops high airway pressures, oliguria, or both.
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4/95. Abdominal compartment syndrome in gynecologic surgery.

    BACKGROUND: Abdominal compartment syndrome is a rare condition in which increased intra-abdominal pressure adversely affects perfusion and viability of the viscera, and the cardiovascular, respiratory, and renal systems. The syndrome follows acute abdominal events such as abdominal trauma, intraperitoneal hemorrhage, or intra-abdominal infection. CASES: Two women who had abdominal hysterectomies postoperatively developed clinical features of multisystem failure with markedly elevated intra-abdominal pressures. The women, one with intra-abdominal infection and diffuse intestinal edema and one with intra-abdominal hemorrhage, were diagnosed by clinical exam and intravesical pressure measurements. Both had follow-up exploration and temporary placement of the small bowel and colon into an intestinal bag until adequate resuscitation was achieved. CONCLUSION: Abdominal compartment syndrome is a rare complication in gynecology that can be diagnosed early and decompressed promptly.
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5/95. forearm fasciotomy post cardiac surgery.

    Compartment syndrome is an uncommon diagnosis in the field of cardiac surgery. early diagnosis and prompt operative decompression are essential for a successful outcome in terms of functional status of the limb concerned and mortality. The management of a compartment syndrome of the forearm is identical to that of the leg.
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6/95. Retroperitoneal compartment syndrome after renal transplantation.

    We report the case of a 21-year-old man with end-stage renal disease secondary to systemic lupus erythematosus who underwent living related renal transplantation and developed an extraperitoneal compartment syndrome postoperatively.
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7/95. fecal impaction causing megarectum-producing colorectal catastrophes. A report of two cases.

    PURPOSE: Massive fecal impaction leading to surgical catastrophes has rarely been reported. We present 2 such patients to remind physicians that neglected accumulation of fecal matter in the rectum may lead to ischemia and perforation of the colon and rectum. methods: Report of 2 patients and a medline search of the literature. RESULTS: In the 1st case massive fecal impaction produced an abdominal compartment syndrome and rectal necrosis. In the 2nd patient fecal impaction resulted in colonic obstruction and ischemia. In both, an operation was life-saving. CONCLUSION: Neglected fecal impaction may lead to a megarectum causing an abdominal compartment syndrome and colorectal obstruction, perforation or necrosis. Measures to prevent fecal impaction are of paramount importance and prompt manual disimpaction before the above complications develop is mandatory. Appropriate operative treatment may be life-saving.
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8/95. Abdominal compartment syndrome in children: experience with three cases.

    BACKGROUND/PURPOSE: Abdominal compartment syndrome (ACS) is defined as cardiopulmonary or renal dysfunction caused by an acute increase in intraabdominal pressure. Although the condition is well described in adults, particularly trauma patients, little is known about ACS in children. methods: Three girls, ages 4, 5, and 5 years, were treated for ACS by silo decompression. Each child presented in profound shock, required massive fluid resuscitation, and had tremendous abdominal distension. The first child sustained a thoracoabdominal crush injury, underwent immediate celiotomy for splenic avulsion and a liver laceration, and required decompression 5 hours postoperatively. The second underwent ligation of her bluntly transected inferior vena cava; because of massive edema, her abdominal wall could not be closed, and prophylactic decompression had to be performed. The third presented with shock of unknown etiology, and ACS developed acutely with a bladder pressure of 26 mm Hg. RESULTS: Respiratory, renal, and hemodynamic function improved immediately in all 3 patients after decompression. Subsequently, each child underwent abdominal wall reconstruction and recovered uneventfully. CONCLUSIONS: ACS is a potentially lethal complication of severe trauma and shock in children. To prevent the development of renal or cardiopulmonary failure in these patients, decompression should be considered for acute, tense abdominal distension.
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9/95. Orbital compartment syndrome caused by intraorbital bacitracin ointment after endoscopic sinus surgery.

    PURPOSE: To present an unusual case of orbital compartment syndrome after endoscopic sinus surgery. methods: Case report. RESULTS: Acute proptosis, chemosis, decreased vision, and ophthalmoplegia were found immediately after endoscopic sinus surgery. Ophthalmologic evaluation showed a tense orbit, and intraocular pressure increased to 54 mm Hg. Treatment was initiated and the intraocular pressure dropped. Computed tomography (CT) revealed the presence of bacitracin ointment in the orbit. CONCLUSION: Ophthalmic complications after sinus surgery are well identified. Postoperative orbital compartment syndrome may be caused by retrobulbar hemorrhage, edema, air (emphysema), or foreign material. In this case, the findings were caused by inadvertent injection of bacitracin ointment into the orbit.
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10/95. Compartment syndrome from balloon pump.

    A 35-year-old man had significant left main coronary artery disease and required intra-aortic balloon catheter insertion owing to refractory ischemia before emergency coronary artery bypass graft. In the immediate postoperative period the patient started complaining of leg pain and diminished sensation in the right foot despite palpable pulses. The diagnosis of acute compartment syndrome of the right leg was made by an intracompartment pressure measurement of 90 mm Hg.
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