[Compartment syndrome following a hematoma in leg muscles, initially interpreted as deep venous thrombosis].
An otherwise healthy 48-year-old Caucasian male was admitted to hospital due to suspicion of right calf thrombosis. The symptoms were intermittent thickening and tension of the right calf for four days. There was no history of trauma. Clinical signs and symptoms and a d-dimer of 1.4 (< 0.5 mg/l) indicated deep venous thrombosis, and anticoagulation treatment was started with confirmatory ultrasound planned for the following morning. Overnight, the pains and swelling increased significantly and decreased sensitivity on the medial side of the foot was found, suggesting compartment syndrome. Ultrasound showed no sign of DVT, but a large haematoma was seen in the deep posterior compartment of the calf, and an acute fasciotomy was done. This case report emphasizes the importance of utilising ultrasound before starting anticoagulation therapy in patients suspected of having DVT.
Munch
Tina Nørgaard
TN
H:S Bispebjerg Hospital, Kardiologisk Klinik Y, Medicinsk Center. tinamunch@tiscali.dk
Jespersen
Christian
C
D003161:Compartment Syndromes / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D003937:Diagnosis, Differential; D006406:Hematoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000175:diagnosis*