[Bilateral compartment syndrome after surgical perfusion for chronic ischemia of the lower extremities].
A 61-year-old man diagnosed with advanced stage Leriche syndrome underwent revascularization surgery with placement of an aortobifemoral shunt and prosthesis under combined general and lumbar epidural anesthesia. After 6 hours he developed bilateral lower extremity compartment syndrome with acute anuric kidney failure caused by severe rhabdomyolysis. Thirty hours after surgery the patient suffered cardiac arrest due to hyperkalemia and was unresponsive to advanced cardiopulmonary resuscitation. The delay in diagnosis, in part owing to the epidural block provided for surgery, and loss of muscle mass led to the unfavorable outcome in this case.
Mendieta
J M
JM
Servicio de Anestesiología y Reanimación, Hospital General Universitario de Alicante.
Rubio
J
J
Elías
M
M
Company
R
R
D058186:Acute Kidney Injury / Q000209:etiology; D000767:Anesthesia, Epidural / Q000009:adverse effects; D001002:Anuria / Q000209:etiology; D001012:Aorta, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology*; D042241:Early Diagnosis; D017809:Fatal Outcome; D005263:Femoral Artery / Q000601:surgery*; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D006947:Hyperkalemia / Q000209:etiology; D007925:Leriche Syndrome / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D015427:Reperfusion Injury / Q000150:complications* / Q000175:diagnosis; D012206:Rhabdomyolysis / Q000209:etiology