title: Delayed compartment syndrome following brachiocephalic arteriovenous fistula formation in a hemodialysis patient.
abstract: Delayed compartment syndrome following the surgical creation of an arteriovenous fistula (AVF) for vascular access is rare. A 71-year-old male patient experienced left anterior forearm compartment syndrome caused by a brachiocephalic AVF. The fistula failed after five days. Immediate radiological de-clotting failed and the thrombosed ﬁstula was de-clotted with the help of a Fogarty balloon. On Day 11, the patient developed symptoms and signs of acute anterior forearm compartment syndrome and underwent immediate surgical decompression of the superficial and deep flexor compartments, which resulted in an excellent outcome. Iatrogenic forearm compartment syndrome is a rare but potential complication after creation of AVF. The critical errors regarding compartment syndrome are failure to recognize or failure to act. This case report illustrates that swift diagnosis and immediate surgical intervention results in an excellent outcome and avoids the morbidity associated with this potentially devastating and debilitating process.
authors.affiliation: Department of Plastic Surgery, Ruhr University Bochum, Bochum, North Rhine-Westphalia, Germany. sammy.al-benna@ruhr-uni-bochum.de
authors.forename: Sammy
authors.initials: S
authors.lastname: Al-Benna
authors.forename: Haussam
authors.initials: H
authors.lastname: Elenin
mesh_terms: D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D019299:Decompression, Surgical; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D006435:Renal Dialysis; D013997:Time Factors; D017211:Treatment Failure; D034941:Upper Extremity / Q000098:blood supply*; D058106:Wound Closure Techniques; D014945:Wound Healing