Compartment syndrome associated with lithotomy position and intermittent compression stockings.
BACKGROUND
Compartment syndrome is a condition in which increased tissue pressure within a limited tissue space compromises the circulation and function of the contents of the space.


METHODS
A 43-year-old black woman, para 3, had repair of a recurrent vesicovaginal fistula. She was placed in a low lithotomy position with thigh length sequential compression sleeves. The procedure lasted more than 5 hours. On postoperative day 1, she complained of pain in her right leg and foot. Compartment syndrome was diagnosed and emergency fasciotomy was done.


CONCLUSIONS
Gynecologists should be aware of the possibility of compartment syndrome during prolonged procedures with patients in the lithotomy position. Concomitant intermittent compression sleeves might further increase the risk. Early diagnosis and treatment of compression syndrome are essential to minimize long-term neurovascular morbidity.
Cohen
S A
SA
Department of Obstetrics and Gynecology, Virginia Commonwealth University, Medical College of Virginia Hospitals, PO Box 980034, Richmond, VA 23298-0034, USA. stcohen@hsc.vcu.edu
Hurt
W G
WG
D000328:Adult; D001458:Bandages / Q000009:adverse effects; D003161:Compartment Syndromes / Q000209:etiology* / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007866:Leg / Q000601:surgery; D016683:Supine Position; D014719:Vesicovaginal Fistula / Q000601:surgery*