scholarly journals Compartment Syndrome following Bothrops Snakebite Leads to Decompressive Fasciotomies

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Murilo Sérgio Valente-Aguiar ◽  
Bruno Gonçalves da Costa e Silva ◽  
Teresa Magalhães ◽  
Ricardo Jorge Dinis-Oliveira
Keyword(s):  
Compartment Syndrome ◽  
Lower Limb ◽  
Severe Pain ◽  
Clinical Course ◽  
Tropical Disease ◽  
Morbidity And Mortality ◽  
Neglected Tropical Disease ◽  
The Right

Snakebite envenoming is a neglected tropical disease with relevant morbidity and mortality. In this report, we illustrate the clinical course of a suspected Bothrops snakebite envenoming of a patient that evidenced severe pain, edema, pallor, regional lymphadenopathy, ecchymosis, myonecrosis, and bullous erythema in the right lower limb, specially around the fang marks. The clinical course progressed to compartment syndrome followed with decompressive fasciotomies to reduce pressure within the affected compartment.

Gluteal Compartment Syndrome Following Abdominal Aortic Aneurysm Treatment

2016 ◽  
Vol 15 (4) ◽  
pp. 354-359 ◽  
Author(s):  
Emanuela Viviani ◽  
Anna Maria Giribono ◽  
Donatella Narese ◽  
Doriana Ferrara ◽  
Giuseppe Servillo ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Postoperative Period ◽  
Lower Limb ◽  
Acute Ischemia ◽  
Aorta Aneurysm ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Kissing Stent ◽  
The Right ◽  
Gluteal Compartment Syndrome

Compartment syndrome (CS) is a pathological increase of the interstitial pressure within the closed osseous fascial compartments. Trauma is the most common cause, followed by embolization, burns, and iatrogenic injuries; it usually involves the limbs. The major issue when dealing with CS is the possibility to do an early diagnosis in order to intervene precociously, through a fasciotomy, reducing the risk of tissue, vascular and nervous damage. Although it is an infrequent condition, it is potentially life threatening. In our case report, we present a 59-year-old patient, smoker, affected by hypertension, dyslipidemia, chronic renal failure, and morbid obesity who came at our attention for a 6-cm abdominal aorta aneurysm, treated with an aorto-aortic graft. Within 24 hours from surgery, the patient presented acute ischemia of the right lower limb due to thrombosis of the common iliac artery and underwent the positioning of a kissing stent at the aortic bifurcation. In the immediate postoperative period, a relevant increase in serum creatinine, creatine phosphokinase, and myoglobin value was recorded, associated with clinical presentation of swelling in the right buttock with intense pain. The diagnosis of gluteal CS was confirmed by the measurement of the gluteal compartment pressure, which resulted of 110 mm Hg. The treatment of the CS consisted in gluteal dermofasciotomy, surgical debridement of the buttock, and positioning of negative pressure medication, associated with infusive therapy, avoiding hemodialysis. Because of the epidural anesthesia only later on it was possible to observe a persistent plegia of the right lower limb, which was solved within 1 month of neurological and physical therapy. With our experience, we can state that the CS is an extremely severe complication that can occur in vascular surgeries and it should therefore be kept in mind in the short-term postoperative period in order to guarantee a precocious diagnosis and immediate treatment.

scholarly journals Idiopathic spontaneous compartment syndrome of the right lower limb: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Sareesh Bandapaati ◽  
Rayno Navinan Mitrakrishnan
Keyword(s):  
Risk Factors ◽  
Compartment Syndrome ◽  
Lower Limb ◽  
Clinical Signs ◽  
Acute Compartment Syndrome ◽  
Gradual Evolution ◽  
Lower Limb Pain ◽  
History Of ◽  
Extrinsic Risk ◽  
The Right

Abstract Background Acutely painful lower limb is a common presentation to the emergency department, and acute compartment syndrome is an important differential diagnosis to consider given the correct predisposing history and clinical presentation. However, idiopathic spontaneous compartment syndrome is an uncommon occurrence. Case presentation A 54-year-old Caucasian man with no previous comorbidities presented with acute right-sided lower limb pain with classical symptoms showing gradual evolution. He had no other history of medical relevance and no preceding injury. Examination showed a marginally enlarged right lower limb with stretched skin and tenderness. Routine blood tests were normal including D-dimer levels. However, in the absence of any underlying risk factors, acute compartment syndrome was suspected on clinical merit and confirmed with magnetic resonance imaging. He underwent successful surgical intervention with fasciotomy and achieved good recovery. Discussion Acute compartment syndrome, though commonly attributed to trauma, can occur due to varied causes. Spontaneous acute compartment syndrome is attributed to diabetes mellitus. Idiopathic acute spontaneous compartment syndrome occurs in the absence of either intrinsic or extrinsic risk factors and is rarely documented in the literature. This case highlights the importance of appreciating classical clinical signs and having the clinical acumen to consider an obvious diagnosis even in its rarer form of presentation.

When snakebites complicate: a paediatric case with shock and compartment syndrome

2021 ◽  
Vol 14 (2) ◽  
pp. e240206
Author(s):  
Joana Carvalho ◽  
Rita Moinho ◽  
Patricia Macao ◽  
Guiomar Oliveira
Keyword(s):  
Emergency Management ◽  
Compartment Syndrome ◽  
Severe Pain ◽  
Clinical Signs ◽  
Upper Arm ◽  
Early Administration ◽  
Surgical Interventions ◽  
Paediatric Case ◽  
Distributive Shock ◽  
The Right

We report the case of an 11-year-old boy brought to our emergency department 2 hours after a viper bite to his right hand. He suffered severe pain and rapidly progressive swelling with signs of haemodynamic compromise in keeping with distributive shock. The oedema progressed from his right wrist upwards to his forearm and upper arm with compartment syndrome ultimately resulting. He underwent fasciotomy of the right upper limb and antivenom serum was given. The patient required vasopressors for 48 hours and a total of nine surgical interventions were necessary. In the event of a snakebite, it is essential to promptly recognise the signs of severity, complications and indications for the administration of antivenom serum. We intend to highlight this rare shock aetiology and the need for emergency management if severe clinical signs are present. Early administration of antivenom serum is essential and it should be available in all emergency departments.

Vulvar herpes zoster infection: a rare and challenging diagnosis

2021 ◽  
Vol 14 (12) ◽  
pp. e246797
Author(s):  
Matilde Matos Martins ◽  
Patrícia Ferreira ◽  
Raquel Maciel ◽  
Cristina Costa
Keyword(s):  
Herpes Zoster ◽  
Lower Limb ◽  
Severe Pain ◽  
Clinical History ◽  
Symptomatic Improvement ◽  
Serological Testing ◽  
Review Of The Literature ◽  
Herpes Zoster Infection ◽  
The Right

A 26-year-old woman under immunosuppression with infliximab due to Crohn’s disease was referred to the gynaecology emergency room with dispersed and coalescing vesicular lesions on the vulvar region extending to the right lower limb involving S2–S3 dermatome, associated with severe pain. Clinical history, physical examination and serological testing was consistent with herpes zoster infection. The patient was treated with valaciclovir for 14 days and cefradine for 7 days (due to the possibility of secondary bacterial infection). Significant symptomatic improvement was noted after 1 week. The 1-year follow-up was unremarkable. According to our knowledge and review of the literature, this is one of the few cases reported of vulvar herpes zoster, especially related to infliximab.

scholarly journals Neurobrucellosis with Gait disturbance: A Neurological Case Report

2020 ◽  
Author(s):  
Soraya Mehrabi ◽  
Elahe Shahriari ◽  
Motahareh Afrakhteh ◽  
Mitra Ranjbar ◽  
Marjan Zeinlai ◽  
...  
Keyword(s):  
Lower Limb ◽  
Clinical Course ◽  
Good Health ◽  
Young Female ◽  
Clinical Tests ◽  
Left Lower Limb ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Brucellosis is a multi-system infectious disease that exhibits with various manifestations and complications. Neurobrucellosis is a rare but serious presentation of brucellosis that can be discovered in every stages of the disease. Laboratory tests and physical examination and patient history are generally the basis for diagnosing the disease. It has both insidious and prolonged clinical course of the disease and long-term therapies. Also the most common pattern of exhibition is subacute or chronic. We reported a case of young female who had history of painless weakness in the right lower limb (proximal and distal) that started gradually and had progressed over the time, and after a month she felt weakness in the left lower limb with the same pattern. Lumbosacral Magnetic resonance imaging (MRI) with and without contrast was shown evidence of enhancement thickening of caudal equina ventral roots. Brucella antigen titer was positive, the result was 1/160. And other clinical tests were normal. Patient treated with Intravenous injection (IV) Rifampicin and Intravenous Cotrimoxazole. patient was discharged with good health and continuinng all two medications for 5 months. The descision was taken to report this case as a result of entire respond in patient’s illness after a enduring disease. Neurobrucellosis is a treatable disease in which it would be better to consider a high indication of suspicion. Due to if ignored, it may cause significant morbidity and mortality.

scholarly journals Angio-Seal™ Embolization: A Rare Etiology of an Acute Distal Limb Ischemia

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Glenmore Lasam ◽  
Joshua Brad Oaks ◽  
Jeffrey Brensilver
Keyword(s):  
Compartment Syndrome ◽  
Femoral Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Vascular Complication ◽  
Closure Device ◽  
Lower Limb Ischemia ◽  
Diagnostic Cardiac Catheterization ◽  
The Right

We herein report a serious vascular complication of diagnostic cardiac catheterization due to an embolization of an Angio-Seal closure device causing acute lower limb ischemia. The Angio-Seal was deployed via the right femoral artery following the catheterization which embolized several hours later to the right popliteal artery. Fogarty embolectomy restored perfusion to the right lower limb; however, compartment syndrome subsequently developed which required evacuation of a hematoma and repair of right popliteal artery.

Acute complications in the post-anaesthesia care unit after infrainguinal surgery for lower limb ischaemia – a prospective observational cohort study

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 89-97
Author(s):  
Karin Yeung ◽  
Jonas Peter Eiberg ◽  
Henrik Kehlet ◽  
Eske Kvanner Aasvang
Keyword(s):  
Lower Limb ◽  
Severe Pain ◽  
Observational Cohort Study ◽  
Limb Ischaemia ◽  
Post Anaesthesia Care Unit ◽  
Lower Limb Ischaemia ◽  
Acute Complications ◽  
Observational Cohort ◽  
Anaesthesia Care ◽  
Pacu Stay

Abstract. Background: Arterial surgery for lower limb ischaemia is a frequently performed procedure in patients with severe cardio-pulmonary comorbidities, making them high-risk patients for acute postoperative complications with a need for prolonged stay in the post-anaesthesia care unit (PACU). However, detailed information on complications during the PACU stay is limited, hindering mechanism-based interventions for early enhanced recovery. Thus, we aimed to systematically describe acute complications and related risk factors in the immediate postoperative phase after infrainguinal arterial surgery. Patients and methods: Patients transferred to the PACU after infrainguinal arterial surgery due to chronic or acute lower limb ischaemia were consecutively included in a six-month observational cohort study. Pre- and intraoperative data included comorbidities as well as surgical and anaesthetic technique. Data on complications and treatments in the PACU were collected every 15 minutes using a standardised assessment tool. The primary endpoint was occurrence of predefined moderate or severe complications occurring during PACU stay. Results: In total, 155 patients were included for analysis. Eighty (52 %) patients experienced episodes with oxygen desaturation (< 85 %) and moderate or severe pain occurred in 72 patients (47 %); however, circulatory complications (hypotension, tachycardia) were rare. Preoperative opioid use was a significant risk factor for moderate or severe pain in PACU (59 vs. 38 % chronic vs. opioid naïve patients (P = 0.01). Conclusions: Complications in the PACU after infrainguinal arterial surgery relates to saturation and pain, suggesting that future efforts should focus on anaesthesia and analgesic techniques including opioid sparing regimes to enhance early postoperative recovery.

Giant right coronary artery aneurysm

2020 ◽  
Vol 28 ◽  
pp. 1-3
Author(s):  
Alexandre Bonfim ◽  
Ronald Souza ◽  
Sérgio Beraldo ◽  
Frederico Nunes ◽  
Daniel Beraldo
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Clinical Course ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Coronary Artery Aneurysms ◽  
History Of ◽  
Artery Disease ◽  
The Right

Right coronary artery aneurysms are rare and may result from severe coronary disease, with few cases described in the literature. Mortality is high, and therapy is still controversial. We report the case of a 72-year-old woman with arterial hypertension, and a family history of coronary artery disease, who evolved for 2 months with episodes of palpitations and dyspnea on moderate exertion. During the evaluation, a giant aneurysm was found in the proximal third of the right coronary artery. The patient underwent surgical treatment with grafting of the radial artery to the right coronary artery and ligation of the aneurysmal sac, with good clinical course.

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