Bilateral Gluteal Compartment Syndrome: A Rare but Potentially Morbid Entity

Abstract

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.

Risk of Anticoagulation in Gluteal Compartment Syndrome After Surgical Intervention

“…Trauma is also one of the most common causes of GCS [1,13]. There are some described cases associated with pelvic fractures and also one case associated with hip dislocation [21][22][23][24][25][26]. We believe the second case presented here to be the first reported case of gluteal compartment syndrome as a result of intertrochanteric fracture.…”

Gluteal Compartment Syndrome after Robotic Left Adrenalectomy

“…2 The compartments can be easily exposed with a ''question mark-shaped'' incision. 3 The incision starts at the posterosuperior iliac spine and extends approximately 10 cm superolaterally along the iliac crest. The incision is then curved inferiorly over the greater trochanter to the level of the inferior gluteal fold.…”

“…Care is taken to preserve the superior gluteal artery and the posterior cutaneous nerves during this mobilization. 3 Gluteal compartment syndrome most commonly occurs in individuals who have undergone long operative procedures and have remained in one position for an extended period of time. The prolonged compression leads to muscle edema, rhabdomyolysis, and compartment syndrome.…”