Said Ahmad, Halalau Alexandra
Internal Medicine, Beaumont Health System, Royal Oak, Michigan, USA.
Internal Medicine, Oakland University, Rochester, Michigan, USA.
BMJ Case Rep. 2018 Jan 24;2018:bcr-2017-222842. doi: 10.1136/bcr-2017-222842.
A 39-year-old woman with a history of chronic back pain due to spinal haemangiomas, multiple malignancies and depression was brought by Emergency medical servicesS to the emergency centre (EC) after being found unresponsive on the bathroom floor. The patient had an exacerbation of her back pain the previous day for which she admitted to taking double her usual dose of oxycodone, in addition to alprazolam, lorazepam, diphenhydramine and a glass of wine. She reported that she lost consciousness and was down for over 8 hours. In the EC, she complained of right forearm pain which was accompanied by mild diffuse soft-tissue swelling and decreased sensation in the right hand. Radial pulse was intact. Creatine kinase was found to be at 4663 U/L. The patient was found to have acute compartment syndrome and underwent emergent forearm fasciotomy. She eventually regained full function of the right arm.
一名39岁女性,有因脊柱血管瘤、多种恶性肿瘤和抑郁症导致的慢性背痛病史,在被发现倒在浴室地板上失去意识后,被紧急医疗服务人员送往急诊中心(EC)。患者前一天背痛加重,她承认除了服用阿普唑仑、劳拉西泮、苯海拉明和一杯葡萄酒外,还加倍服用了她平常剂量的羟考酮。她报告说自己失去了意识,并且长达8个多小时不省人事。在急诊中心,她主诉右前臂疼痛,伴有轻度弥漫性软组织肿胀和右手感觉减退。桡动脉搏动正常。肌酸激酶水平为4663 U/L。该患者被诊断为急性骨筋膜室综合征,并接受了紧急前臂筋膜切开术。她最终右臂恢复了全部功能。