Rare complication of four extremity compartment syndrome requiring fasciotomy from influenza A viral myositis

2021 ◽  
Vol 14 (1) ◽  
pp. e236893
Author(s):  
Arion Lochner ◽  
Robert Cesaro ◽  
Eric Chen
Keyword(s):  
Compartment Syndrome ◽  
Influenza A ◽  
Unusual Case ◽  
Healthy Adult ◽  
Rare Complication ◽  
Skin Grafting ◽  
Severe Illness ◽  
Delayed Primary Closure ◽  
High Risk Populations

Influenza A and B commonly cause benign respiratory disease in humans, but can cause more severe illness in high-risk populations. We report an unusual case of a previously healthy adult patient who presented with myositis and severe rhabdomyolysis secondary to influenza A infection that resulted in atraumatic compartment syndrome of all four extremities, each requiring emergent fasciotomy. The patient was subsequently managed with delayed primary closure and skin grafting in the operating room. Prompt recognition of this rare complication by the team resulted in no limb amputations. On his first follow-up appointment, 1 month after discharge, he had regained full functionality in both his hands and his feet were both close to 50% of baseline and improving with physical therapy.

Acute Compartment Syndrome of Upper Extremities with Tendon Ruptures

2017 ◽  
Vol 22 (04) ◽  
pp. 411-415
Author(s):  
Taku Suzuki ◽  
Eiko Yamabe ◽  
Takuji Iwamoto ◽  
Katsuji Suzuki ◽  
Harumoto Yamada ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Compartment Syndrome ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Skin Grafting ◽  
High Energy ◽  
Acute Compartment Syndrome ◽  
Mechanism Of Injury ◽  
Sensory Disturbances

Background: It is well known that acute compartment syndrome is associated with fracture of the forearm, while involvement of soft tissue injury including musculotendinous injury remains unclear. The purpose of this study was to evaluate the soft tissue involvement, including musculotendinous ruptures, in acute compartment syndrome of the upper limb. Methods: We retrospectively enrolled 16 patients who underwent surgical treatment for acute compartment syndrome of the upper extremity. The average age of the patients was 47 years (range, 14 to 79) and the mean follow-up period after the surgery was 15 months (range, 12 to 29). Complications included at least one presentation at the final follow up of sensory disturbances or motor disturbances. We examined the presence of musculotendinous injury mechanism of injury, presence of fracture, the performance of skin grafting, and complications. Results: Mechanism of injury of “caught in a machine” was found in six cases. Three of these patients had musculotendinous ruptures and all muscle tears were revealed by intraoperative findings. No patients had muscle ruptures with other injury mechanisms. Seven out of 16 patients (44%) developed complications at final follow-up. Skin grafting was performed in six patients, and five of these patients developed complications. Only one of the nine patients without complications underwent skin grafting. Conclusions: In cases of high-energy injuries, the surgeon should suspect the presence of a musculotendinous injury prior to surgery.

Shoe-Lace Technique Hasten Delayed Primary Closure In Fasciotomy Wound For Forearm Compartment Syndrome

2021 ◽  
Vol 7 (2) ◽  
pp. 76-78
Author(s):  
Mohd Asha'ari Bain ◽  
Mohd Shaffid Md Shariff ◽  
Mohamad Hilmi Mohamad Nazarallah ◽  
Nur Dina Azman ◽  
Abu 'Ubaidah Amir Norazmi
Keyword(s):  
Compartment Syndrome ◽  
Primary Closure ◽  
Open Fracture ◽  
Wound Closure ◽  
Skin Grafting ◽  
Delayed Primary Closure ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Forearm Compartment Syndrome ◽  
Good Cosmesis

We report a case of acute compartment syndrome of the forearm in a 51-year-old man with open fracture distal third radius (Gustilo I).  Decompressive fasciotomy was performed promptly. Complete progressive closure of the wound without split-thickness skin grafting was achieved using a shoe-lace technique: silastic vessel loop were interlaced held together with skin staplers placed at the edge of the fasciotomy wound and were then tightened daily. Delayed primary closure of the fasciotomy wound was performed after 8 days post fasciotomy with complete opposition of skin edges without tension. Shoelace closure is a good option for atraumatic fasciotomy wound closure with good cosmesis result.

scholarly journals Cutaneous anthrax of the hand: Some clinical observations

2004 ◽  
Vol 37 (02) ◽  
pp. 131-133
Author(s):  
Dogan Tuncali ◽  
Unzile B. Akbuga ◽  
Gurcan Aslan
Keyword(s):  
Compartment Syndrome ◽  
Fibrous Tissue ◽  
Dorsal Surface ◽  
Skin Grafting ◽  
The United States ◽  
Skin Defect ◽  
Upper Arm ◽  
Clinical Observations ◽  
Cutaneous Anthrax

ABSTRACT CONTEXT: Anthrax is a very rare disease in Europe and the United States. AIM: A case of cutaneous anthrax of the hand with a wide skin defect is presented and some clinical observations highlighted. CASE REPORT: A 56-year-old male patient with cutaneous anthrax attended our infectious diseases department with a swelling up to the upper arm. An urgent fasciotomy was undertaken with a diagnosis of compartment syndrome. A black eschar had formed on the dorsal surface of the hand. A superficial tangential escharectomy was performed. RESULTS: Viable fibrous tissue, about 4 to 5 mm in thickness over the extensor tendons, was found under the eschar. At the postoperative 2-year follow-up, remarkable healing was observed via skin grafting. CONCLUSIONS: Hand surgeons should be cautious against the compartment syndrome that may accompany cutaneous anthrax of the hand. A consistent viable fibrous tissue can be found below the eschar. The mechanism for the involvement of the hand dorsum needs further concern.

scholarly journals Chronic Bilateral Calcified Subdural Empyema: An Unusual Complication of a Ventriculoperitoneal Shunt

2020 ◽  
Vol 6 (4) ◽  
pp. 225-228
Author(s):  
Abdoulaye Diop ◽  
◽  
Mohameth Faye ◽  
Roger Ilunga Mulumba ◽  
Momar Codé Ba ◽  
...  
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Unusual Case ◽  
Rare Complication ◽  
Infectious Complications ◽  
Subdural Empyema ◽  
Unusual Complication ◽  
Shunt Valve ◽  
Late Morbidity ◽  
Common Technique

Background and Importance: Subdural empyema is a rare complication of ventriculoperitoneal shunts. The ventriculoperitoneal shunt is a common technique used in the treatment of hydrocephalus. It is often plagued with multiple complications, especially infectious ones. However, the appearance of infectious complications related to ventriculoperitoneal shunt remotely from surgery is rather unusual. Case Presentation: Through this observation, we are reporting an unusual case of chronic bilateral calcified subdural empyema which occurred 8 years after ventriculoperitoneal shunt surgery. The child underwent a bilateral craniotomy in order to evacuate the empyema and meanwhile remove the valve. One month later, the empyema relapsed along with active hydrocephalus. Consequently, the implementation of an external ventricular shunt was performed and the child benefited from adapted antibiotic therapy. After the infection was treated, a second ventriculoperitoneal shunt valve was implemented. Afterwards, the evolution was favorable, the child retained a discrete left hemiparesis as a sequel. Conclusion: This observation is reporting the existence of late morbidity due to the insertion of a ventriculoperitoneal valve; which shows that a regular and prolonged follow-up is necessary in children with a ventriculoperitoneal shunt valve.

scholarly journals 600 Bilateral Upper Limb Compartment Syndrome After Massive Postpartum Haemorrhage

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Payne ◽  
S Elahi
Keyword(s):  
Compartment Syndrome ◽  
Upper Limb ◽  
Unusual Case ◽  
Postpartum Haemorrhage ◽  
Skin Grafting ◽  
Trauma Patients ◽  
Capillary Refill ◽  
Left Hand ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Abstract Case Summary Upper limb compartment syndrome (ULCS) is an uncommon limb-threatening emergency occurring as a result of increased interstitial pressure within osteofascial compartments. The overwhelming majority of causes occur in one limb, with frequent causes including fractures, reperfusion injury and burns. We report the unusual case of bilateral upper limb CS in a previously well 35-year-old female secondary to massive resuscitation following postpartum haemorrhage. The patient received 7 litres of blood products and 4 litres of crystalloid over a period of 8 hours. One hour postoperatively both hands became painful and swollen. Symptoms worsened over the following hour: both forearms were tense to palpate with demonstrable pain on passive extension of bilateral wrists and digits of the left hand, and capillary refill to all digits was brisk. Creatinine kinase was measured at 4,600U/L and bilateral forearm and left-hand fasciotomies were performed. The presence of bulging muscles in both forearms and the left hand confirmed the diagnosis of compartment syndrome, and perfusion was restored to all digits after release of the compartments. The patient later underwent split thickness skin grafting to both forearms and left-hand fasciotomy wounds. After 5 weeks of hand therapy, she regained good function of both hands. Bilateral ULCS is extremely uncommon but has been reported secondary to massive resuscitation, particularly in trauma patients, and we suspect that this was the cause in our patient.

scholarly journals Massive sialadenitis resulting in critical airway after elective craniotomy: case report

2016 ◽  
Vol 18 (4) ◽  
pp. 475-479
Author(s):  
Aditya Vedantam ◽  
Daniel Hansen ◽  
Bradley Daniels ◽  
Sandi Lam
Keyword(s):  
Case Report ◽  
Unusual Case ◽  
Early Recognition ◽  
Rare Complication ◽  
Temporal Lobectomy ◽  
Brachial Plexopathy ◽  
Airway Compromise ◽  
Neck Swelling ◽  
Anterior Temporal Lobectomy

The authors report an unusual case of acute, rapidly progressive, unilateral neck swelling following extubation after elective left anterior temporal lobectomy with amygdalohippocampectomy. Due to severe neck swelling, the patient developed critical airway compromise, brachial plexopathy, and Horner's syndrome. After critical airway management and appropriate rehabilitation, the patient recovered completely and remains seizure free at 1.5 years of follow-up. This case highlights the importance of early recognition of acute postoperative sialadenitis and the steps needed to prevent serious morbidity and possible mortality from this rare complication.

scholarly journals Ibuprofen-Induced Aseptic Meningitis in a Male Adolescent with Intracranial Hypertension and Visual Impairment: A Case Report

2021 ◽  
Vol 13 (1) ◽  
pp. 233-238
Author(s):  
Seyed Mohammad Mousavi Mirzaei ◽  
Zahra Ahmadi
Keyword(s):  
Visual Impairment ◽  
Intracranial Hypertension ◽  
Aseptic Meningitis ◽  
Rare Complication ◽  
Clinical Signs ◽  
Male Adolescent ◽  
Drug Induced ◽  
Blurred Vision ◽  
Inflammatory Drugs

Drug-induced aseptic meningitis (DIAM) is a rare complication of certain drugs, most commonly reported with ibuprofen use. The present study reports on a male adolescent with intracranial hypertension and visual impairment accompanied by DIAM. We present a 16-year-old male patient who after ibuprofen consumption displayed headache, fever, photophobia, and blurred vision following heavy exercises. Examination of cerebrospinal fluid showed a mononuclear pleocytosis and an increase in protein concentration. Other examinations had normal results. The development of common clinical signs following ibuprofen use reflected DIAM. The patient’s vision was found to improve with supportive care and stopping of the drug during follow-up. Given the widespread use of nonsteroidal anti-inflammatory drugs and the fact that these drugs are the most common cause of DIAM, the probability of occurrence of this event should be always kept in mind, and screening for autoimmune diseases in these patients is of great importance.

scholarly journals Influenza A (H1N1) virus infection and TNF-308, IL6, and IL8 polymorphisms in Egyptian population: a case–control study

2019 ◽  
Vol 80 (1) ◽  
Author(s):  
Shaimaa Moustafa Elsayed ◽  
Omayma Mohamed Hassanein ◽  
Nagwa Hassan Ali Hassan
Keyword(s):  
Influenza A ◽  
Case Control Study ◽  
H1n1 Virus ◽  
Case Control ◽  
Severe Illness ◽  
Study Results ◽  
Influenza A H1n1 ◽  
Pandemic Strains ◽  
Study Participants ◽  
Control Study

Abstract Background The importance of influenza is increasing mainly because of the appearance of novel pandemic strains such as swine and avian. Each year, influenza has spread around the world causing about 250,000–500,000 deaths and more than 5 million cases of severe illness. The objective is as follows: evaluating the outcomes of patients with influenza A (H1N1) virus in relation to certain TNF-308, IL6, and IL8 polymorphisms and identifying the associated factors with the severe outcome. Subject and methods This is a case–control study. The cases were patients confirmed by real-time polymerase chain reaction (RT-PCR) to be influenza A (H1N1) virus infected. The controls were healthy individuals. Medical history and outcome of the disease was registered. In all study participants, polymorphisms of TNF rs1800629, IL6 rs18138879, and IL8 rs4073; odds ratio (OR); and the 95% confidence interval (95% CI) were calculated. Results Infection with influenza A (H1N1) virus was associated more with the following genotypes: TNF-308 AA (OR = 4.041; 95% CI = 1.215–13.4) and IL8 AA (OR = 3.273; 95% CI = 1.372–7.805). According to our study results, HCV (OR = 3.2, 95% CI 1.2–8.5), renal disease (OR = 3.4, 95% CI 0.9–13.6), cancer (OR = 3.1, 95% CI 0.3–31.1), TB (OR = 8.4, 95% CI 1.8–39.7), ICU (OR = 2.9, 95%1.2–7.1), and mortality (OR = 7.9, 95% CI 0.9–67.4) are considered as risk factors for influenza A (H1N1)-infected patients. Conclusions Our findings concluded that TNF-308 (AA) and IL8 (AA) polymorphisms may increase the susceptibility to be infected with H1N1influenza virus.

scholarly journals Innovative method for Amplatzer device implantation in patients with bronchopleural fistulas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jisong Zhang ◽  
Huihui Hu ◽  
Li Xu ◽  
Shan Xu ◽  
Jihong Zhu ◽  
...  
Keyword(s):  
Present Report ◽  
Rare Complication ◽  
Bronchopleural Fistula ◽  
Rigid Bronchoscopy ◽  
New Approach ◽  
Device Implantation ◽  
Amplatzer Device ◽  
Field Of Vision ◽  
Duration Of Operation

Abstract Background Bronchopleural fistula (BPF) is a relatively rare complication after various types of pulmonary resection. The double-sided mushroom-shaped occluder (Amplatzer device, AD) has been gradually used for BPF blocking due to its reliable blocking effect. We have improved the existing AD implantation methods to facilitate clinical use and named the new approach Sheath-free method (SFM). The aim of the present report was to explore the reliability and advantages of the SFM in AD implantation. Methods We improved the existing implantation methods by abandoning the sheath of the AD and using the working channel of the bronchoscope to directly store or release the AD without general anesthesia, rigid bronchoscopy, fluoroscopy, or bronchography. A total of 6 patients (5 men and 1 woman, aged 66.67 ± 6.19 years [mean ± SD]) had BPF blocking and underwent the SFM in AD implantation. Results AD implantation was successfully performed in all 6 patients with the SFM, 4 persons had a successful closure of the fistula, one person died after few days and one person did not have a successful closure of the fistula. The average duration of operation was 16.17 min (16.17 ± 4.67 min [mean ± SD]). No patients died due to operation complications or BPF recurrence. The average follow-up time was 13.2 months (range 10–17 months). Conclusion We observed that the SFM for AD implantation—with accurate device positioning and a clear field of vision—is efficient and convenient. The AD is effective in BPF blocking, and could contribute to significantly improved symptoms of patients.

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