Brown Rodger H, Downey Cara, Izaddoost Shayan
Division of Plastic Surgery, Baylor College of Medicine, Clinical Care Center, 6701 Fannin, CC 610, Houston, TX 77030 USA.
Hand (N Y). 2011 Mar;6(1):110-4. doi: 10.1007/s11552-010-9305-5. Epub 2010 Oct 26.
While isolated limb injuries often lead to suspicion for and treatment of compartment syndrome, multi-limb compartment syndrome induced by a systemic disease is a rare entity, in which lack of immediate diagnosis can have catastrophic consequences to the patient. We present a patient with idiopathic systemic capillary leak syndrome (SCLS) resulting in compartment syndrome in all four extremities. Treatment required bilateral hand, forearm, calf, and thigh fasciotomies. Presenting symptoms included pain in all four extremities, malaise, and confusion. Laboratory data included polycythemia, hypoalbuminemia, leukocytosis, and elevated creatinine, but not a monoclonal spike on serum electrophoresis as is common in SCLS. Thus, when faced with clinical evidence of multiple extremity compartment syndrome, the surgeon should consider systemic disorders, such as SCLS, and aggressively treat the compartment syndrome as well as the underlying disease.
虽然孤立的肢体损伤常常会引发对骨筋膜室综合征的怀疑并进行相应治疗，但由全身性疾病引起的多肢体骨筋膜室综合征却是一种罕见的病症，若不能及时诊断，可能会给患者带来灾难性后果。我们报告了一例患有特发性全身性毛细血管渗漏综合征（SCLS）的患者，该综合征导致其四肢均出现骨筋膜室综合征。治疗需要进行双侧手部、前臂、小腿和大腿的筋膜切开术。患者的症状包括四肢疼痛、不适和意识模糊。实验室检查数据包括红细胞增多症、低白蛋白血症、白细胞增多症和肌酐升高，但血清电泳中没有SCLS常见的单克隆峰。因此，当面对多肢体骨筋膜室综合征的临床证据时，外科医生应考虑全身性疾病，如SCLS，并积极治疗骨筋膜室综合征以及潜在疾病。
