[A case of acute renal failure caused by rhabdomyolysis with thrombosis of the deep vein of the right leg, following sleeping in a straight sitting position for a long time].
A 41-year-old woman took an overdose of sedatives on the 13th of January, 1994 and remained a sleep in the straight sitting position until she was woken up on the 15th. The next day she consulted our hospital complaining of pain and swelling of her right leg. X-ray examination with contrast medium revealed obstruction of the deep vein of her right leg by a thrombus. On the 17th, her serum urea nitrogen was 75.9 mg/dl and creatinine was 5.4 mg/dl accompanied by oliguria. The myoglobin value was 27,000 ng/ml in serum and 88,000 ng/ml in urine. She was diagnosed as acute renal failure caused by rhabdomyolysis and hemodialysis therapy was started. She was released from hemodialysis on the 31th of January. The swelling of her right leg disappeared at the end of February. However, her right foot was affected paralysis of the fibular nerve. Electromyogram of her right anterotibial muscle and the test of conduction velocity of right tibial nerve revealed that the neurological disturbance of her right leg was caused by thrombosis of the deep vein. Generally speaking, the swelling of the extremities resulting from rhabdomyolysis caused by crush syndrome is due to a massive shift of body-fluid into the crushed muscles. We believe that when the extremities are compressed (and/or crushed) for a long time, venous thrombosis of the extremities occurs due to compression, there by causing swelling of the compressed extremities, as in this case.
Konishi
N
N
Department of Internal Medicine, Shinwakai Kyoto-Min-Iren Daini-Chuoh Hospital, Japan.
Takeshita
K
K
D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D005260:Female; D006801:Humans; D011187:Posture; D012206:Rhabdomyolysis / Q000150:complications*; D012890:Sleep; D013924:Thrombophlebitis / Q000150:complications*; D013997:Time Factors