Bilateral Gluteal Compartment Syndrome: A Rare but Potentially Morbid Entity

2010 ◽  
Vol 76 (7) ◽  
pp. 752-754 ◽  
Author(s):  
Jose Castro-Garcia ◽  
Brian R. Davis ◽  
Miguel A. Pirela-Cruz
Keyword(s):  
Compartment Syndrome ◽  
Operating Room ◽  
Illicit Drug ◽  
Early Recognition ◽  
Lumbar Pain ◽  
Interstitial Pressure ◽  
Sensory Deficits ◽  
Illicit Drug Abuse ◽  
The Right ◽  
Gluteal Compartment Syndrome

Compartment syndrome is caused by elevated interstitial pressure within the myofascial compartment. It rarely presents bilaterally in the gluteal region. A 49-year-old man fell 10 feet from a roof on his buttocks. He presented 10 hours after the injury with intense lumbar pain. Both glutei were exceptionally tense. There were no vascular injuries or sensory deficits. Compartmental pressures measured 60 mm Hg on the left side and 50 mm Hg on the right side. The patient was taken to the operating room for decompressive fasciotomy. The glutei compartments were released. He was taken once more to the operating room, requiring only minimal debridement. He was discharged the next week with no neurological deficit. Bilateral gluteal compartment syndrome is very rare with few cases reported in the literature. It has been associated with trauma, prolonged recumbence, surgical instrumentation, and illicit drug abuse. Early recognition is required to avoid the potential severe metabolic and physical deficits.

scholarly journals Delayed Presentation of Gluteal Compartment Syndrome: The Argument for Fasciotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
John E. Lawrence ◽  
Duncan J. Cundall-Curry ◽  
Kuldeep K. Stohr
Keyword(s):  
Compartment Syndrome ◽  
Kidney Injury ◽  
Limb Ischaemia ◽  
Delayed Presentation ◽  
Neurological Improvement ◽  
Tertiary Centre ◽  
Acute Limb Ischaemia ◽  
Nerve Recovery ◽  
The Right ◽  
Gluteal Compartment Syndrome

A male patient in his fifties presented to his local hospital with numbness and weakness of the right leg which left him unable to mobilise. He reported injecting heroin the previous morning. Following an initial diagnosis of acute limb ischaemia the patient was transferred to a tertiary centre where Computed Tomography Angiography was reported as normal. Detailed neurological examination revealed weakness in hip flexion and extension (1/5 on the Medical Research Council scale) with complete paralysis of muscle groups distal to this. Sensation to pinprick and light touch was globally reduced. Blood tests revealed acute kidney injury with raised creatinine kinase and the patient was treated for rhabdomyolysis. Orthopaedic referral was made the following day and a diagnosis of gluteal compartment syndrome (GCS) was made. Emergency fasciotomy was performed 56 hours after the onset of symptoms. There was immediate neurological improvement following decompression and the patient was rehabilitated with complete nerve recovery and function at eight-week follow-up. This is the first documented case of full functional recovery following a delayed presentation of GCS with sciatic nerve palsy. We discuss the arguments for and against fasciotomy in cases of compartment syndrome with significant delay in presentation or diagnosis.

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 Gluteal Compartment Syndrome and Rhabdomyolysis after Prolonged Laparoscopic Nephroureterectomy and Treatment Strategies Including Rehabilitation: A Case Report

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 47
Author(s):  
Jae-Gyeong Jeong ◽  
Seock Hwan Choi ◽  
Ae-Ryoung Kim ◽  
Jong-Moon Hwang
Keyword(s):  
Blood Sample ◽  
Compartment Syndrome ◽  
Treatment Strategies ◽  
Chronic Phase ◽  
Operation Time ◽  
Patient Specific ◽  
Normal Ranges ◽  
Muscular Injury ◽  
The Right ◽  
Gluteal Compartment Syndrome

Background: Rhabdomyolysis is a clinical symptom caused by the rapid release of intracellular components such as myoglobin, lactate dehydrogenase, and creatine kinase into the blood circulation. It is commonly caused by muscular injury including compartment syndrome, infection, drugs, etc. Although it rarely occurs during surgery, the incidence may increase if risk factors such as long operation time, improper posture, and condition of being overweight exist. Case Presentation: A 46-year-old male patient complained of pain and weakness in the right hip area and several abnormal findings were observed in the blood sample, reflecting muscle injury and decreased renal function after prolonged urological surgery. He was confirmed as having rhabdomyolysis, which was caused by compartment syndrome of the right gluteal muscle. After the diagnosis, conservative cares were performed in the acute phase and rehabilitation treatments were performed in the chronic phase. After conservative treatment and rehabilitation, blood sample values returned to almost normal ranges and both level of pain and muscle strength were significantly improved. In addition, about 25 days after discharge, he almost recovered to pre-operative condition. Conclusion: Careful attention is required to prevent intraoperative compartment syndrome. It also suggests that not only medical treatment but also early patient-specific rehabilitation is important in patients with rhabdomyolysis after prolonged surgery.

scholarly journals Compartment Syndrome: an Acute Femoral Stress Fracture in a Young Male Athlete

2021 ◽  
Author(s):  
Amelie Kanovsky ◽  
Ernst J. Mueller
Keyword(s):  
Compartment Syndrome ◽  
Muscle Mass ◽  
Stress Fracture ◽  
Acute Stress ◽  
Young Male ◽  
Young Males ◽  
Fatigued Muscle ◽  
Fracture Osteosynthesis ◽  
Initial Fracture ◽  
The Right

AbstractThe incidence of an acute compartment syndrome (ACS) of the thigh is less than 1%. It is most common in the setting of muscle overuse or muscle injury, as well as secondary to trauma, such as a femoral fracture. We present a case of an ACS in a young, healthy, and semiprofessional athlete with normal coagulation who sustained an acute stress fracture of the distal femur. After the initial fracture osteosynthesis, the patient suffered from a compartment syndrome in the right anterior aspect of the distal thigh. Following rapid surgical fasciotomy, the case was uneventful, and he returned to his preinjury sport level without any neurological consequences. This case confirms that ACS in the thigh is rare, but mainly occurs in young males with a large muscle mass due to participation in various athletic programs. We hypothesize that constant muscle over-usage primes for a larger amount of contused and protruding muscle mass in the small femoral compartment. Hence, the fatigued muscle subjects the bone to an increased mechanical force resulting in an overloading process. This ensues the accumulation of femoral microfractures and primes for the occurrence of an increased rate of stress fractures and an ACS in the thigh.

Illicit drug abuse

2003 ◽  
pp. 383-402
Author(s):  
Cheryl L. Kunis ◽  
Harry J. Ward ◽  
Gerald B. Appel
Keyword(s):  
Drug Abuse ◽  
Illicit Drug ◽  
Illicit Drug Abuse

scholarly journals Sensory deficits in ipsilesional upper-extremity in chronic stroke patients

2015 ◽  
Vol 73 (10) ◽  
pp. 834-839 ◽  
Author(s):  
Núbia Maria Freire Vieira Lima ◽  
Karina Cândido Menegatti ◽  
Érica Yu ◽  
Natália Yumi Sacomoto ◽  
Thais Botossi Scalha ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Thermal Sensation ◽  
Chronic Stroke ◽  
Sensory Loss ◽  
Stroke Patients ◽  
Sensory Assessment ◽  
Sensory Deficits ◽  
Left Handed ◽  
Right Hemisphere Damage ◽  
The Right

Objective To investigate somatosensory deficits in the ipsilesional wrist and hand in chronic stroke patients and correlate these deficits with contralesional sensorimotor dysfunctions, functional testing, laterality and handedness.Methods Fifty subjects (twenty-two healthy volunteers and twenty-eight stroke patients) underwent evaluation with Semmes-Weinstein monofilaments, the sensory and motor Fugl-Meyer Assessment, the Nottingham Sensory Assessment in both wrists and hands and functional tests.Results Twenty-five patients had sensory changes in the wrist and hand contralateral to the stroke, and eighteen patients (64%) had sensory deficits in the ipsilesional wrist and hand. The most significant ipsilesional sensory loss was observed in the left-handed patients. We found that the patients with brain damage in the right hemisphere had better scores for ipsilesional tactile sensation.Conclusions A reduction in ipsilesional conscious proprioception, tactile or thermal sensation was found in stroke subjects. Right hemisphere damage and right-handed subjects had better scores in ipsilesional tactile sensation.

scholarly journals Psychometric properties of DSM assessments of illicit drug abuse and dependence: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

2007 ◽  
Vol 37 (9) ◽  
pp. 1345-1355 ◽  
Author(s):  
M. T. LYNSKEY ◽  
A. AGRAWAL
Keyword(s):  
Drug Abuse ◽  
Psychometric Properties ◽  
Illicit Drugs ◽  
Illicit Drug ◽  
Item Difficulty ◽  
Descriptive Analysis ◽  
Epidemiological Survey ◽  
Epidemiologic Survey ◽  
Drug Use Disorders ◽  
Illicit Drug Abuse

ABSTRACTBackgroundDSM-IV criteria for illicit drug abuse and dependence are largely based on criteria developed for alcohol use disorders and there is a lack of research evidence on the psychometric properties of these symptoms when applied to illicit drugs.MethodThis study utilizes data on abuse/dependence criteria for cannabis, cocaine, stimulants, sedatives, tranquilizers, opiates, hallucinogens and inhalants from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC, n=43 093). Analyses included factor analysis to explore the dimensionality of illicit drug abuse and dependence criteria, calculation of item difficulty and discrimination within an item response framework and a descriptive analysis of ‘diagnostic orphans’: individuals meeting criteria for 1–2 dependence symptoms but not abuse. Rates of psychiatric disorders were compared across groups.ResultsResults favor a uni-dimensional construct for abuse/dependence on each of the eight drug classes. Factor loadings, item difficulty and discrimination were remarkably consistent across drug categories. For each drug category, between 29% and 51% of all individuals meeting criteria for at least one symptom did not receive a formal diagnosis of either abuse or dependence and were therefore classified as ‘orphans’. Mean rates of disorder in these individuals suggested that illicit drug use disorders may be more adequately described along a spectrum of severity.ConclusionsWhile there were remarkable similarities across categories of illicit drugs, consideration of item difficulty suggested that some alterations to DSM regarding the relevant severity of specific abuse and dependence criteria may be warranted.

Neuropathological Alterations in Illicit Drug Abuse

2012 ◽  
Vol 2 (3) ◽  
pp. 235-241 ◽  
Author(s):  
Andreas Büttner
Keyword(s):  
Drug Abuse ◽  
Illicit Drug ◽  
Illicit Drug Abuse
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