[Bilateral compartment syndrome after colorectal surgery in the lithotomy position].

Abstract

Lower limb compartment syndrome is an unusual but severe complication of prolonged surgery more than four hours in lithotomy position. It is usually a consequence of hypoperfusion of the lower extremities and muscle necrosis may occur. Several risk factors are pointed out: trendelenburg, the hardness of operating table, hypothermia, control hypotension, occlusion of arterial blood flow of the lower extremity, arteritis (and smoking), diabetes, obesity, arterial hypertension, myopathy and an important muscle mass. The symptoms are postoperative pain with neurological signs. A rapid diagnosis and aggressive management (i.e. resuscitation and aponevrotomy) is recommended. Neurological sequelae are sometimes invalidating. Reporting a case of bilateral syndrome, we reviewed the literature and describe the present diagnosis and therapeutic management as well as prevention modalities of this iatrogenic complication.

• Authors: C Tison, C Périgaud, S Vrignaud, M Capelli, P A Lehur
• Journal: Annales de chirurgie (Ann Chir) Vol. 127 Issue 7 Pg. 535-8 (Sep 2002) ISSN: 0003-3944 [Print] France
• Vernacular Title: Syndrome bilatéral des loges de jambe après chirurgie colorectale en position à double équipe.
• PMID: 12404849 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Adenocarcinoma (surgery)
• Compartment Syndromes (diagnosis, etiology, therapy)
• Humans
• Iatrogenic Disease (prevention & control)
• Leg (blood supply)
• Male
• Middle Aged
• Pain, Postoperative (etiology)
• Perioperative Care (methods)
• Postoperative Complications (diagnosis, etiology, therapy)
• Primary Prevention (methods)
• Rectal Neoplasms (surgery)
• Risk Factors
• Supine Position
• Time Factors