Acute atraumatic bilateral peroneal compartment syndrome after dialysis access surgery

Abstract

SCIENTIFIC LETTERACUTE ATRAUMATIC BILATERAL PERONEAL COMPARTMENT SYNDROME AFTER DIALYSIS ACCESS SURGERYReceived: 11/06/2023 Accepted: 11/20/2023 https://doi.org/10.55200/raccv.v22.n1.0062ABSTRACTAcute atraumatic compartment syndrome is a rare entity; of the peroneal compartment, it is even rarer and bilateral even more so. We present the case of a patient who underwent surgery to rescue a brachiocephalic mega-fistula with three aneurysms associated with a stenosis of the cephalic arch. The technique consisted of aneurysmectomy, removal of the excess vein, transposition, and a new anastomosis distal to the axillary vein. The procedure lasted 220 minutes, and general anesthesia was used. The following day, the patient reported left leg paraesthesia, pain, and inability to evert the left foot or walk. Arterial pulses were normal, as was pulse wave Doppler. MRI confirmed peroneal compartment syndrome, and an emergency fasciotomy was performed. While recovering with full sensation and motility for the next 24 hours on the left side, she presented with pain and cramps in the right peroneal compartment without more severe symptoms, so fasciotomy was not performed; the condition resolved spontaneously within 24 hours. This is the first reported case of atraumatic bilateral peroneal compartment syndrome after dialysis access surgery, with full recovery after prompt treatment.