2024-03-28T21:54:22Z
https://tsukuba.repo.nii.ac.jp/oai
oai:tsukuba.repo.nii.ac.jp:00038809
2022-04-27T09:08:43Z
2780:1493
2780:5350
2780:5351
2780:536
2780:7827
3:62:5591:5365
Well leg compartment syndrome after surgery for ulcerative colitis in the lithotomy position: A case report
榎本, 剛史
大原, 佑介
山本, 雅由
小田, 竜也
大河内, 信弘
Enomoto, Tsuyoshi
Ohara, Yusuke
Yamamoto, Masayoshi
Oda, Tatsuya
Ohkohchi, Nobuhiro
© 2016 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
Introduction:
Well leg compartment syndrome (WLCS) is an uncommon and severe complication that occurs after colorectal surgery in the lithotomy position.
Presentation of case:
The current patient was a 28-year-old male suffering from ulcerative colitis. He was underwent elective proctectomy, including ileal J pouch formation and anal anastomosis with temporary loop ileostomy. The ileoanal pouch procedure was quite difficult, and during this procedure, the high lithotomy and head down tilt positions were continued for 255 min.
After the operation, the patient complained of severe cramping pain, swelling and serious tenderness on palpation in both legs. On the first postoperative day, the patient's complaints gradually worsened. The intra-compartmental pressure was measured, and WLCS was diagnosed. Emergency bilateral fasciotomy was performed. Initially, the patient had a sensory deficit and analgesia, however, his sensory disturbance and pain had almost recovered two months after fasciotomy by rehabilitation.
Discussion:
In the current case, the important factors associated with the development of WLCS are thought to be a prolonged operative time in which the patient is placed in the high lithotomy position during ileoanal pouch procedure.
Conclusion:
We would thus like to emphasize that operations for the ileoanal pouch procedure to treat ulcerative colitis have a high potential for inducing WLCS, because it usually requires a prolonged operative time in which the patient remains in the high lithotomy position.
Elsevier
2016
eng
journal article
http://hdl.handle.net/2241/00143479
https://tsukuba.repo.nii.ac.jp/records/38809
27085103
10.1016/j.ijscr.2016.04.006
22102612
International journal of surgery case reports
23
25
28
https://tsukuba.repo.nii.ac.jp/record/38809/files/IJSCR_23.pdf
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986.0 kB
2016-08-02