Amputation in crush syndrome: A case report

Arango-Granados, María Camila; Mendoza, Diego Fernando Cruz; Cadavid, Alexander Ernesto Salcedo; Marín, Alberto Federico García

doi:10.1016/j.ijscr.2020.05.087

Cited by 6 publications

(1 citation statement)

References 18 publications

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“…There seems to be no dispute that surgical decompression is necessary if the peripheral pulses of the extremities are not palpable [ 8 ]. Amputation may be required if vital signs and symptoms progressively worsen despite aggressive resuscitation [ 9 ]. However, our case suggested that if the wound is closed, the peripheral pulse is palpable, and the patient's symptoms have improved, a fasciotomy should not be performed.…”

Section: Discussionmentioning

confidence: 99%

Good recovery without decompression fasciotomy for crush syndrome caused by using a Japanese-style toilet

Osuka

Miyao

Kuge

et al. 2021

Trauma Case Reports

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We report a case of crush syndrome that developed while the patient was squatting to use a Japanese-style toilet. The patient was a 61-year-old male with an obese body. He was sitting on the toilet and couldn't stand up, and after a few hours, the landlord found him and called the emergency services. On presentation, the patient was hyperkalemic and in shock, and his serum creatine kinase levels rose to a maximum of 287,600 U/L. He was diagnosed with postural crush syndrome in both lower extremities due to squatting position in a Japanese-style toilet. Subjective symptoms, physical examination, and blood tests were monitored and the patient was observed. As a result, the patient could be treated conservatively without fasciotomy. Dialysis was not necessary because the fluid infusion maintained adequate urine output and corrected the hyperkalemia. Magnetic resonance imaging of both lower extremities showed multiple high-signal areas in the muscles of the bilateral thighs and lower legs. This case suggested that if the wound is closed, the peripheral pulse is palpable, and the patient's symptoms have improved, a fasciotomy should not be performed. People who are too heavy to squat may need to be careful when using this kind of toilet.

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Section: Discussionmentioning

confidence: 99%

Good recovery without decompression fasciotomy for crush syndrome caused by using a Japanese-style toilet

Osuka

Miyao

Kuge

et al. 2021

Trauma Case Reports

View full text Add to dashboard Cite

show abstract

Methylthioninium chloride/hydrocortisone/vasopressors

2020

Reactions Weekly

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Navigating the ‘Triangle of Death’: A Multidisciplinary Approach in Severe Multi-Trauma Management

Zhang,

Jian,

Wang

et al. 2024

Clin Med Insights Case Rep

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This case report details the challenging management of a 45-year-old male construction worker who suffered severe multiple injuries after a fall and subsequent collision with cement mixers. The patient presented with extensive injuries, including amputation, fractures and internal bleeding, leading to a state known as the ‘triangle of death’. Despite the initial grim prognosis, evidenced by an ISS score of 28 and a mortality risk coefficient of 89.56%, the patient was successfully resuscitated and managed through a multidisciplinary approach. This included damage control resuscitation, emergency vascular interventions and targeted temperature management for brain protection. The patient’s recovery highlights the effectiveness of comprehensive trauma management and the critical role of coordinated care in severe multi-trauma cases.

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Amputation in crush syndrome: A case report

Cited by 6 publications

References 18 publications

Good recovery without decompression fasciotomy for crush syndrome caused by using a Japanese-style toilet

Good recovery without decompression fasciotomy for crush syndrome caused by using a Japanese-style toilet

Methylthioninium chloride/hydrocortisone/vasopressors

Navigating the ‘Triangle of Death’: A Multidisciplinary Approach in Severe Multi-Trauma Management

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