Báo cáo y học: Acute lower limb compartment syndrome after Cesarean section: a case report

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Báo cáo y học: "Acute lower limb compartment syndrome after Cesarean section: a case report" JOURNAL OF MEDICAL CASE REPORTSAcute lower limb compartment syndrome afterCesarean section: a case reportRadosa et al. Radosa et al. Journal of Medical Case Reports 2011, 5:161 http://www.jmedicalcasereports.com/content/5/1/161 (22 April 2011)Radosa et al. Journal of Medical Case Reports 2011, 5:161 JOURNAL OF MEDICALhttp://www.jmedicalcasereports.com/content/5/1/161 CASE REPORTS CASE REPORT Open AccessAcute lower limb compartment syndrome afterCesarean section: a case reportJulia C Radosa1†, Marc P Radosa2*† and Marc Sütterlin1 Abstract Introduction: Acute compartment syndrome of the lower limb is a rare but severe intra- and post-partum complication. Prompt diagnosis is essential to avoid permanent functional restriction or even the loss of the affected limb. Clinical signs and symptoms might be nonspecific, especially in the early stages; therefore, knowledge of predisposing risk factors can be helpful. Case presentation: We present the case of a 32-year-old Caucasian woman with acute post-partum compartment syndrome. Conclusion: Acute compartment syndrome is an important differential diagnosis for the sudden onset of intra- or post-partum lower-limb pain. Predisposing factors for the manifestation of acute compartment syndrome in an obstetric environment are augmented intra-partum blood loss, prolonged hypotensive episodes and the use of oxytocin to support or induce labor because of its vasoconstrictive properties. Treatment is prompt surgical decompression by performing fasciotomy in any affected muscular compartments.Introduction pressure, which subsequently causes compression of thin-walled veins within that compartment [3]. As aAcute limb compartment syndrome (ACS) is a condition result, venous outflow decreases and venous and arterialin which increased pressure within a closed musculofas- intra-vasal pressure increase, which causes diminishedcial compartment compromises blood circulation and perfusion of the affected compartment [4]. The conse-biomechanical function. There are several etiologies of quences of this insufficient perfusion are nerve and mus-ACS. ACS may occur after significant trauma, for exam- cle ischemia. Muscle infarction and lasting nerve damageple, long-bone fractures. Other forms of injury which will occur if prompt surgical decompression is delayed.cause soft tissue damage, such as crush injuries, severe ACS is diagnosed on the basis of clinical evaluation. Inthermal burns and bleeding diathesis are known causes cases with an atypical or unclear clinical presentation,as well. Less frequently ACS may occur in a non- the invasive measurement of compartment pressuretraumatic setting, such as in post-ischemic reperfusion, might be helpful [5]. Continuous monitoring of tissuein revascularization procedures, after the application of oxygen saturation using near infrared spectroscopy hasvasoconstrictive therapeutic agents or in anesthesia- been described as particularly helpful in the diagnosis ofinduced hypotension [1]. An iatrogenic cause, prolonged ACS, because a sudden decrease ...