Iatrogenic Volkmannʼs ischemia—a result of pressure due to transfusion

Maer, P.; Levy, Michael J.; Lotem, M; Fried, A

doi:10.1097/00006534-197302000-00052

Cited by 4 publications

(7 citation statements)

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“…These include attempts at obtaining access in the presence of a coagulopathy [ 4 ] and arterial catheter removal [ 5 ]. Increased tissue pressure with accidental interstitial infusions of packed red cells [ 6 ] or normal saline [ 7 ] as well as hypertonic saline [ 8 ] have also been described. Vascular disruption or catheter misplacement can occur during IV cannulation which may lead to impaired perfusion distal to the injury and increased tissue pressure by the extravasated blood or fluid [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Compressive Ulnar Neuropathy in a Patient of Dengue Fever: An Unusual Presentation

Mehtani

Jha

Kataria

et al. 2013

Journal of Orthopaedic Case Reports

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Introduction:Dengue haemorrhagic fever is known for its haemorrhagic and neurologic complications. Neurologic complications are caused by three mechanism namely neurotropism, systemic complications causing encephalopathy and postinfectious immune-mediated mechanisms. However acute compressive neuropathy due to haemorrhage is not frequent and we could find no literature describing thisCase Report:We report a case of acute compressive ulnar neuropathy due to peri neural hematoma, following an attempt at intravenous cannulation in the cubital fossa in a patient of dengue haemorrhagic fever with thrombocytopenia. Immediate fasciotomy and removal of haematoma was performed to relieve the symptoms.Conclusion:Compression neuropathies can be seen in dengue hemorrhagic fever and removal of compressing hematoma relieves symptoms

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Section: Discussionmentioning

confidence: 99%

Acute Compressive Ulnar Neuropathy in a Patient of Dengue Fever: An Unusual Presentation

Mehtani

Jha

Kataria

et al. 2013

Journal of Orthopaedic Case Reports

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show abstract

“…These include attempts at obtaining access in the presence of a coagulopathy 2 and arterial catheter removal. 3 Increased tissue pressure with accidental interstitial infusions of packed red cells 4 or normal saline 5 as well as hypertonic saline 6 have also been described. Vascular disruption or catheter malplacement can occur during iv cannulation which may lead to impaired perfusion distal to the injury and increased tissue pressure by the extravasated blood or fluid.…”

Section: Discussionmentioning

confidence: 99%

Compartment syndrome following intravenous regional anesthesia

Ananthanarayan

Castro

McKee

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: To present two cases of upper extremity compartment syndrome following intravenous regional anesthesia. Clinical features: Case 1: A 57-yr-old man presented for surgical release of a left-hand Dupuytren's contracture. The procedure was performed under iv regional anesthesia with 360 mg lidocaine and sedation with 150 µg fentanyl and 1.5 mg midazolam. Tourniquet time was 107 min at a pressure of 260 mmHg using three different tourniquet sites. Within minutes of tourniquet release, increased forearm muscle tension, hand anesthesia, pallor, and limited motor function developed. Serum CK and myoglobin levels rose. Myoglobinuria was present. Several fasciotomies and aggressive fluid therapy were performed. Patient made almost full recovery. Case 2: A 73-yr-old woman with controlled hypertension had Dupuytren fasciotomy of her right hand under iv regional anesthesia with 200 mg lidocaine and sedation using 75 µg fentanyl and 1.5 mg midazolam. Tourniquet time was 64 min at a pressure of 250 mmHg using three different tourniquet sites. The patient complained of pain at the iv site during injection of local anesthetic, third tourniquet inflation and after deflation of tourniquet. Thirty minutes after arrival in PACU, her fingers were bluish. She complained of pain and swelling of the forearm. Under general anesthesia, fasciectomy was performed. Myoglobin and CPK levels rose. CPK MB was high but troponin was negative. Three days later she developed pulmonary embolism. She was heparinized and subsequently discharged home. She recovered completely. Conclusion:Compartment syndrome may have a rapid and severe onset. Etiology of our cases is still not established. We postulate that increased tissue pressure may be the cause. The anesthesiologists must be aware of compartment syndrome during regional anesthesia.

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“…ACS of the limb is a relatively rare complication in obstetrics and has an estimated prevalence of 2 in 10,000 births [ 1 ]. Several predisposing risk factors have been described in the published case reports, such as PPH [ 13 , 16 , 18 , 19 ], epidural analgesia [ 16 , 17 ], hypotension [ 9 , 12 , 17 ], vasoconstrictive agents [ 8 , 13 , 16 – 18 ], lithotomy position [ 8 ], and postpartum eclampsia [ 11 , 15 ]; however, a combination of factors may also be responsible [ 8 , 9 , 13 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The published literature estimates a prevalence of 2 in 10,000 births [ 1 ]; however, its true incidence is unknown. It has been reported in the settings of both vaginal [ 8 – 12 ] and cesarean births [ 13 – 19 ] and has been diagnosed on the basis of clinical evaluation and occasionally ICP measurement.…”

Section: Introductionmentioning

confidence: 99%

Acute compartment syndrome of the lower limb following childbirth: a case report

et al. 2020

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Background Acute compartment syndrome is a limb-threatening and occasionally life-threatening emergency that is rarely reported as a complication following childbirth. Prompt diagnosis is crucial to avoid permanent functional restriction or even the loss of the affected limb. Clinical signs and symptoms might be nonspecific, especially in the early stages; therefore, knowledge of predisposing risk factors and signs and symptoms of acute compartment syndrome is necessary to prevent long-term complications and amputation. Case presentation This paper presents a case of a 26-year-old primiparous Sri Lankan woman who developed acute compartment syndrome of the lower right limb following childbirth by cesarean section. Conclusion Acute compartment syndrome is an important differential diagnosis in the setting of sudden onset of lower limb pain following childbirth. Predisposing factors for its manifestation within an obstetric environment are augmented labor, the lithotomy position, postpartum hemorrhage, hypotension following epidural analgesia, and the use of vasoconstrictive agents. If left undiagnosed and untreated, acute compartment syndrome may cause permanent neurovascular deficit, leading to a poor functional result, tissue ischemia, limb amputation, and rhabdomyolysis. If severe, and in large compartments, it can lead to renal failure and death. Alertness and a high index of clinical suspicion for the possibility of acute compartment syndrome are required to avoid a delay in diagnosis, and intracompartmental pressure measurement can be used to confirm the diagnosis.

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Iatrogenic Volkmannʼs ischemia—a result of pressure due to transfusion

Cited by 4 publications

References 0 publications

Acute Compressive Ulnar Neuropathy in a Patient of Dengue Fever: An Unusual Presentation

Acute Compressive Ulnar Neuropathy in a Patient of Dengue Fever: An Unusual Presentation

Compartment syndrome following intravenous regional anesthesia

Acute compartment syndrome of the lower limb following childbirth: a case report

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