Hepatic compartment syndrome complicating a right laparoscopic nephrectomy and treated by surgical decompression

2021 ◽  
Author(s):  
G. Lacroix ◽  
E. Boleslawski ◽  
J.-R. Nzamushe
Keyword(s):  
Compartment Syndrome ◽  
Surgical Decompression ◽  
Laparoscopic Nephrectomy

Complete Bilateral Brachial Plexus Injury from Rhabdomyolysis and Compartment Syndrome: Surgical Case Report

2018 ◽  
Vol 17 (2) ◽  
pp. E68-E72 ◽  
Author(s):  
Daniel A Tonetti ◽  
Ivan S Tarkin ◽  
Kiran Bandi ◽  
John J Moossy
Keyword(s):  
Brachial Plexus ◽  
Compartment Syndrome ◽  
Clinical Presentation ◽  
Brachial Plexus Injury ◽  
Laboratory Data ◽  
Surgical Decompression ◽  
Sensory Function ◽  
Resonance Imaging ◽  
Pectoralis Muscles ◽  
Prolonged Immobilization

Abstract BACKGROUND AND IMPORTANCE Acute bilateral brachial plexus injury is rare and usually a result of traction injury. Immediate operative intervention is reserved for rare cases of ongoing compression of the plexus; the role for acute decompression of the brachial plexus secondary to compartment syndrome has not been previously described. In this report, we describe the technique and role for urgent brachial plexus decompression. CLINICAL PRESENTATION A 32-yr-old man presented with acute complete bilateral brachial plexus palsy due to focal rhabdomyolysis and brachial plexus compression after a night of excess alcohol and methadone ingestion. He had complete loss of motor and sensory function from C5 to T1, with the exception of partial sensory sparing of the C5 dermatome. Magnetic resonance imaging demonstrated diffuse muscular edema of the supraclavicular and infraclavicular fossae in addition to the pectoralis muscles and the deltoids bilaterally. He underwent urgent surgical decompression of his supraclavicular and infraclavicular fossae with fasciotomies of the pectoral muscles and the anterior deltoids, allowing direct visualization and decompression of the entire brachial plexus resulting in a near-complete functional recovery. CONCLUSION Neurosurgeons should include brachial plexus compression due to compartment syndrome in the differential diagnosis of patients with acute upper extremity weakness, particularly when associated with prolonged immobilization and/or substance abuse. Prompt surgical decompression should be performed in these patients if imaging and laboratory data suggest compartment syndrome and resultant neurological deficit.

scholarly journals The Pathophysiology, Diagnosis and Current Management of Acute Compartment Syndrome

2014 ◽  
Vol 8 (1) ◽  
pp. 185-193 ◽  
Author(s):  
James Donaldson ◽  
Behrooz Haddad ◽  
Wasim S Khan
Keyword(s):  
Compartment Syndrome ◽  
Tissue Perfusion ◽  
Surgical Decompression ◽  
Acute Compartment Syndrome ◽  
Definitive Treatment ◽  
Interstitial Pressure ◽  
Compartment Pressure ◽  
Current Management ◽  
Ischaemic Damage

Acute compartment syndrome (ACS) is a surgical emergency warranting prompt evaluation and treatment. It can occur with any elevation in interstitial pressure in a closed osseo-fascial compartment. Resultant ischaemic damage may be irreversible within six hours and can result in long-term morbidity and even death. The diagnosis is largely clinical with the classical description of ‘pain out of proportion to the injury’. Compartment pressure monitors can be a helpful adjunct where the diagnosis is in doubt. Initial treatment is with the removal of any constricting dressings or casts, avoiding hypotension and optimizing tissue perfusion by keeping the limb at heart level. If symptoms persist, definitive treatment is necessary with timely surgical decompression of all the involved compartments. This article reviews the pathophysiology, diagnosis and current management of ACS.

Acute Paraspinal Muscle Compartment Syndrome Treated with Surgical Decompression

2002 ◽  
Vol 30 (2) ◽  
pp. 283-285 ◽  
Author(s):  
Izuru Kitajima ◽  
Shintaro Tachibana ◽  
Yutaka Hirota ◽  
Kenichi Nakamichi
Keyword(s):  
Compartment Syndrome ◽  
Surgical Decompression ◽  
Paraspinal Muscle ◽  
Muscle Compartment

scholarly journals Hand Compartment Syndrome

2021 ◽  
Author(s):  
Ioannis M. Stavrakakis ◽  
George E. Magarakis ◽  
Theodoros H. Tosounidis
Keyword(s):  
Compartment Syndrome ◽  
Pressure Measurement ◽  
High Pressures ◽  
Signs And Symptoms ◽  
Surgical Decompression ◽  
Clinical Image ◽  
Loss Of Function ◽  
Intracompartmental Pressure ◽  
Permanent Loss ◽  
Hand Disability

Compartment syndrome is defined by high pressures in a closed myofascial compartment, which affects initially the muscles and later the nerves and vessels. The hand is rarely affected, but if treated suboptimally, it results to a permanent loss of function. Eleven compartments are included in the hand and wrist. Diagnosis of compartment syndrome of the hand remains challenging. Pain out of proportion of injury and excessive swelling should raise suspicion towards a compartment syndrome. Intracompartmental pressure measurement contributes to the diagnosis, but it is not always reliable. Once the diagnosis of acute compartment syndrome has been made, decompression of all compartments is mandatory, in order to achieve a good outcome. Failing to manage this emergent condition properly leads to a significant hand disability. Our chapter includes the following sections: 1. Introduction. A brief description of the hand compartment syndrome is presented. 2. Anatomy. Special considerations regarding hand compartments are presented, 3. Etiology. 4. Diagnosis. Signs and symptoms are reported, as well as guidelines of the technique of intracompartmental pressure measurement. 5. Treatment. Faciotomies’ indications and operative technique are described in details. 6. Conclusion. Appropriate figures of the clinical image and surgical decompression are presented as well.

scholarly journals To close or not to close? Treatment of abdominal compartment syndrome by neuromuscular blockade without laparostomy

2010 ◽  
Vol 92 (7) ◽  
pp. e8-e9 ◽  
Author(s):  
J Davies ◽  
A Aghahoseini ◽  
J Crawford ◽  
DJ Alexander
Keyword(s):  
Compartment Syndrome ◽  
Neuromuscular Blockade ◽  
Abdominal Compartment Syndrome ◽  
Gold Standard ◽  
Standard Treatment ◽  
Surgical Decompression ◽  
Successful Management ◽  
Abdominal Compartment ◽  
Prolonged Neuromuscular Blockade ◽  
Nasogastric Decompression

Abdominal compartment syndrome (ACS) is a recognised postoperative complication seen frequently in the intensive care unit (ICU). Surgical decompression and laparostomy remain the gold standard treatment for established ACS, combined with supportive non-surgical therapy, such as nasogastric decompression. In the following case report, we describe our successful management of a patient with established postoperative ACS by re-laparotomy to exclude a reversible cause, immediate re-closure of the abdomen and prolonged neuromuscular blockade, avoiding a laparostomy.

scholarly journals Acute upper limb compartment syndrome in children: special focus on nerve recovery

2020 ◽  
Vol 3 (3) ◽  
pp. e000158
Author(s):  
Terrence Jose Jerome
Keyword(s):  
Compartment Syndrome ◽  
Upper Limb ◽  
Full Range ◽  
Nerve Fibers ◽  
Surgical Decompression ◽  
Acute Compartment Syndrome ◽  
Time Interval ◽  
Special Focus ◽  
Sensory Recovery

BackgroundMany studies have discussed acute compartment syndrome in children associated with or without fractures and have given their visible perspectives. Little is known about the nerve involvement and the factors associated with recovery patterns in these patients. We intend to propose that ischemic nerve and muscles tend to regenerate after surgical decompression but in a different pattern and the given circumstances.MethodsTwenty-four children with acute compartment syndrome in the upper limb were analyzed between 2009 and 2015. Data included demographic features of these patients, the time interval between the injury and surgery, and the attempt to correlate with motor and sensory recovery.ResultsThe average follow-up was 67.3 months (range 59–80). Of the 24, 14 patients (58%) had immediate recovery of motor and sensory functions. The remaining 10 patients had variable recovery patterns with a mean time for the radial nerve, median nerve and ulnar nerve motor recovery of 6.0, 7.5 and 8.5 months, respectively, and sensory recovery at 12, 12 and 13 months, respectively. The overall study had a mean sensory recovery as per the Medical Research Council (MRC) of S3 in 3 (12%) and S4 in 21 (88%). The mean 2-point discrimination (2PD) was 6.9 mm (range 5–10). Twenty-one patients (88%) had a full range of movements at their final follow-up with a mean Visual Analog Scale score of 0.6; a quick Disabilities of the Arm, Shoulder and Hand score of 5.9 (range 2.3–25.0) and a Mayo wrist score of 79.ConclusionsThere was a definite motor and sensory recovery in patients who underwent surgical decompression in acute compartment syndrome of the upper limb irrespective of age, gender, delay in presentation and various etiologies. The motor and nerve fibers can regenerate after ischemic sequela of compartment syndrome.

scholarly journals Abdominal Compartment Syndrome—When is Surgical Decompression Needed?

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2294
Author(s):  
Dan Nicolae Păduraru ◽  
Octavian Andronic ◽  
Florentina Mușat ◽  
Alexandra Bolocan ◽  
Mihai Cristian Dumitrașcu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Aortic Aneurysm ◽  
Compartment Syndrome ◽  
Observational Studies ◽  
Surgical Intervention ◽  
Surgical Decompression ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Severe Burns ◽  
Abdominal Aortic ◽  
Abdominal Compartment

Compartment syndrome occurs when increased pressure inside a closed anatomical space compromises tissue perfusion. The sudden increase in pressure inside these spaces requires rapid decompression by means of surgical intervention. In the case of abdominal compartment syndrome (ACS), surgical decompression consists of a laparostomy. The aim of this review is to identify the landmarks and indications for the appropriate moment to perform decompression laparotomy in patients with ACS based on available published data. A targeted literature review was conducted on indications for decompression laparotomy in ACS. The search was focused on three conditions characterized by a high ACS prevalence, namely acute pancreatitis, ruptured abdominal aortic aneurysm and severe burns. There is still a debate around the clinical characteristics which require surgical intervention in ACS. According to the limited data published from observational studies, laparotomy is usually performed when intra-abdominal pressure reaches values ranging from 25 to 36 mmHg on average in the case of acute pancreatitis. In cases of a ruptured abdominal aortic aneurysm, there is a higher urgency to perform decompression laparotomy for ACS due to the possibility of continuous hemorrhage. The most conflicting recommendations on whether surgical treatment should be delayed in favor of other non-surgical interventions come from studies involving patients with severe burns. The results of the review must be interpreted in the context of the limited available robust data from observational studies and clinical trials.

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