title: Small incision fasciotomy in a patient with compartment syndrome and peripheral arterial occlusive disease.
abstract: An 82-year-old-man with a previous history of atrial fibrillation was admitted with acute limb ischemia. Emergent embolectomy was performed, but after the operation, the patient suffered from recurrent ischemic pain. Peripheral angiography revealed thrombosis of the distal popliteal artery due to pre-existing peripheral arterial occlusive disease. Bypass surgery of the popliteal artery and posterior tibial artery was then performed. Although peripheral blood flow was restored after the operation, he suffered from compartment syndrome the next day. The patient was treated with an emergent bed-side fasciotomy using a small incision, achieving full recovery of blood flow to the distal artery. The wound closed secondarily without surgical closure. In a patient with peripheral arterial occlusive disease, fasciotomy should be performed at a lower compartment pressure due to a lack of peripheral perfusion pressure. Emergent small incision fasciotomy was effective in this patient with an acute compartment syndrome and an ischemic limb.
authors.affiliation: Department of Cardiovascular Surgery, Showa University, Fujigaoka Hospital, Kanagawa, Japan. dougskgh05@yahoo.co.jp
authors.forename: Daijiro
authors.initials: D
authors.lastname: Hori
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Noguchi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Nomura
authors.forename: Alan
authors.initials: A
authors.lastname: Lefor
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D003161:Compartment Syndromes / Q000209:etiology / Q000601:surgery*; D000071938:Fasciotomy; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects*; D058106:Wound Closure Techniques