Brachial muscle injury resulting in acute compartment syndrome of the upper arm: a case report and literature review

Abstract Background Acute compartment syndrome (ACS) is a potentially devastating condition. ACS is rare in the upper arm. Case presentation We report a case of acute compartment syndrome of the anterior compartment of the upper arm due to brachial muscle injury. The patient experienced abnormal progressive swelling and pain in his right upper arm, and passive pulling pain of the right wrist and right hand. It was highly suspected to be right upper arm compartment syndrome, and was confirmed by surgery. The patient transferred to the emergency operating room for fasciotomy that was performed under general anesthesia using the anterolateral approach. The brachial muscle was found to be heavily swollen and had the greatest tension. The brachial muscle fibers were split lengthwise, and a large amount of hematoma was cleared. The brachial muscles were injured and partly ruptured. After full decompression, a negative pressure drainage device was used to cover the wound in the first stage. Ten days after injury, the swelling of the affected limb subsided and the wound was sutured. The patient’s limbs completely recovered to normal. The shoulder and elbow joints could move freely and the patient resumed normal farming work ability. Conclusion Clinicians should fully recognize the fact that acute compartment syndrome can occur in the upper arm, rather than only the forearm and leg, and therefore avoid serious consequences caused by missed diagnosis and misdiagnosis.

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Acute compartment syndrome in the upper arm

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2016.10.029 ◽

2017 ◽

Vol 35 (3) ◽

pp. 525.e1-525.e2 ◽

Cited By ~ 3

Author(s):

Natasha Thomas ◽

Brian Cone

Keyword(s):

Compartment Syndrome ◽

Acute Compartment Syndrome ◽

Upper Arm

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Acute compartment syndrome of the lower leg causing cardiac arrest after resection of the right external iliac vein for autologous graft: a case report

JA Clinical Reports ◽

10.1186/s40981-019-0286-2 ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Koji Hoshino ◽

Toru Nakamura ◽

Mineji Hayakawa ◽

Yusuke Itosu ◽

Hitoshi Saito ◽

...

Keyword(s):

Cardiac Arrest ◽

Portal Vein ◽

Compartment Syndrome ◽

Iliac Vein ◽

Lower Leg ◽

Acute Compartment Syndrome ◽

External Iliac Vein ◽

Portal Vein Reconstruction ◽

Vein Resection ◽

The Right

Abstract Background The right external iliac vein (REIV) is often used for portal vein reconstruction in patients undergoing pancreatoduodenectomy with portal-superior mesenteric vein resection. We report a case of cardiac arrest caused by acute lower leg compartment syndrome as a result of REIV resection. Case presentation A 53-year-old man underwent pancreatoduodenectomy with portal vein resection. Hyperkalemia progressed during surgery due to intestinal reperfusion injury, which caused recurrent ventricular arrhythmia required for cardio-pulmonary resuscitation. The surgery was discontinued after resuscitation, and portal vein reconstruction using the REIV was performed 2 days post-operatively. Acute compartment syndrome was diagnosed immediately following the surgery. Hyperkalemia progressed, causing pulseless ventricular tachycardia. Emergent fasciotomy was performed, but right leg dysfunction persisted after discharge. Conclusion REIV resection can cause lower-extremity acute compartment syndrome. The status, including intracompartmental pressure, of the lower extremity should be carefully observed after REIV resection during and after surgery.

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Acute Compartment Syndrome of the right lower extremity following Autologous Blood transfusion: A Case report

International Journal of Cardiovascular Practice ◽

10.21859/ijcp-010302 ◽

2016 ◽

Vol 1 (3) ◽

pp. 22-24

Author(s):

Feridun Sabzi ◽

Aghigh Heidari ◽

Fataneh Ghasemi ◽

Abbas Ahmadi

Keyword(s):

Case Report ◽

Blood Transfusion ◽

Lower Extremity ◽

Compartment Syndrome ◽

Autologous Blood ◽

Acute Compartment Syndrome ◽

Autologous Blood Transfusion ◽

The Right

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Crimean-Congo haemorrhagic fever presenting with acute compartment syndrome of the extremities (think beyond normal infections)

BMJ Case Reports ◽

10.1136/bcr-2019-232323 ◽

2020 ◽

Vol 13 (2) ◽

pp. e232323

Author(s):

Ishma Aijazi ◽

Fadhil Mustafa Abdulla Al Shama ◽

Yaseen Shandala ◽

Rupa Murthy Varghese

Keyword(s):

Hospital Admission ◽

Compartment Syndrome ◽

Disseminated Intravascular Coagulation ◽

Direct Contact ◽

Acute Compartment Syndrome ◽

Haemorrhagic Fever ◽

Cchf Virus ◽

History Of ◽

Crimean Congo Haemorrhagic Fever ◽

The Right

Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonosis transmitted to humans and animals (which act as a reservoir) through the bite of a ‘Hyalomma’ tick. CCHF virus belongs to the genus Nairovirus. Humans are infected when they come in direct contact with the blood or secretions of infected livestock or other infected humans. This disease initially presents with non-specific febrile symptoms common to many viral illnesses and later progresses to disseminated intravascular coagulation (DIC) with haemorrhagic manifestations.We present the case of a middle-aged man with CCHF. He presented to the hospital with DIC and acute compartment syndrome in the right forearm, requiring urgent orthopaedic intervention. The diagnosis was delayed because there was no clear history of contact. The patient was started taking ribavirin on the fifth day of hospital admission. He recovered fully.

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

BMJ Case Reports ◽

10.1136/bcr-2020-240206 ◽

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.

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Acute Compartment Syndrome Of The Upper Arm

The Internet Journal of Orthopedic Surgery ◽

10.5580/ed5 ◽

2006 ◽

Vol 3 (1) ◽

Cited By ~ 1

Keyword(s):

Compartment Syndrome ◽

Acute Compartment Syndrome ◽

Upper Arm

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

Journal of Medical Case Reports ◽

10.1186/s13256-021-02683-y ◽

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.

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Intermittent Massage as a Therapeutic Option for Compartment Syndrome after Embolectomy of the Lower Limbs

Case Reports in Vascular Medicine ◽

10.1155/2018/2679358 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

José Maria Pereira de Godoy ◽

Maria de Fátima Guerreiro Godoy

Keyword(s):

Compartment Syndrome ◽

Therapeutic Option ◽

Venous Drainage ◽

Burning Sensation ◽

Lower Limbs ◽

Arterial Embolism ◽

Anterior Compartment ◽

Slight Pain ◽

The Right ◽

Sole Of The Foot

The case of a 54-year-old cardiac patient is reported, who was admitted to hospital with a complaint of sudden pain in the legs associated with edema, paresthesia, and coldness. Arterial embolism of the lower limbs was diagnosed and the patient was submitted to bilateral embolectomy. The patient evolved with a burning sensation, hypersensitivity in the right leg, swelling, and difficulty bending and stretching the sole of the foot and the knee. A physical examination detected edema and increased tension in the anterior, lateral, and posterior compartments. Treatment using intermittent massage of the leg during the evaluation of the patient was chosen in an attempt to stimulate lymphatic and venous drainage. After a few minutes of stimulation, there was significant improvement in the pain and edema. In 40 minutes, there was total reduction of the pain in the posterior and lateral compartments and improvement of over 50% in the anterior compartment. After this, the patient started to bend the knee without pain and bend the sole of the foot with slight pain. On the following day, the patient was walking around the hospital ward without difficulty. It seems that intermittent massage is a therapeutic option in selected cases of compartment syndrome.

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Traumatic Rupture and Herniation of the Peroneus Tertius Muscle Leading to Compartment Syndrome and Entrapment of the Superficial Peroneal Nerve: A Case Report

The Surgery Journal ◽

10.1055/s-0041-1731423 ◽

2021 ◽

Vol 07 (03) ◽

pp. e154-e157

Author(s):

Jussi Repo ◽

Mikko Ovaska ◽

Eetu N. Suominen ◽

Henrik Sandelin ◽

Jani Puhakka

Keyword(s):

Case Report ◽

Compartment Syndrome ◽

Peroneal Nerve ◽

Anatomical Variations ◽

Traumatic Rupture ◽

Lateral Part ◽

Superficial Peroneal Nerve ◽

Operating Theater ◽

Anterior Compartment ◽

The Right

AbstractWe present a patient with compartment syndrome and entrapment of the superficial peroneal nerve due to a direct hit to the lateral part of the right lower extremity. The diagnosis of evolving compartment syndrome was made without delay and the patient was quickly taken to the operating theater. Intraoperatively, the entrapment of the superficial peroneal nerve caused by rupture and herniation of the peroneus tertius muscle was surprisingly observed at the site, where the nerve pierces the anterior compartment. The nerve was successfully released in conjunction with fasciotomies of the anterior and lateral compartments. Meticulous diagnosis of compartment syndrome is critical to prevent ischemic injury to muscles and nerves. Recognition of anatomy and anatomical variations is important to prevent iatrogenic injury in unusual circumstances.

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