Hirji Sameer A, Karamchandani Manish M, Scott Jonathan W, Menard Matthew T
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Case Rep Surg. 2019 Jul 9;2019:7085219. doi: 10.1155/2019/7085219. eCollection 2019.
Iliacus compartment syndrome is a rare clinical condition which can result in a severe, unilateral, femoral neuropraxia. Recognition of this syndrome as the cause of a developing neuropathy is often delayed given a lack of familiarity with this clinical diagnosis and the retroperitoneal location of the iliacus muscle. Prompt diagnosis is important to avoid risk of consequent muscle necrosis, rhabdomyolysis, and possibly permanent nerve injury. We describe a case of iliacus compartment syndrome in an elderly, frail woman with end-stage renal disease, anticoagulated for atrial fibrillation, who presented with subacute, progressive lower extremity muscle weakness and pain in the setting of complicated metabolic derangements. She was found to have a spontaneous large hematoma in her left iliacus muscle on computed tomography scan. Despite an initial diagnostic delay, she was successfully managed with an iliacus fasciotomy, which led to complete resolution of her symptoms.
髂肌间隙综合征是一种罕见的临床病症，可导致严重的单侧股神经失用。鉴于对该临床诊断缺乏了解以及髂肌位于腹膜后位置，将此综合征识别为正在发展的神经病变的病因往往会延迟。及时诊断对于避免随后发生肌肉坏死、横纹肌溶解以及可能的永久性神经损伤的风险很重要。我们描述了一例患有终末期肾病、因心房颤动接受抗凝治疗的老年体弱女性的髂肌间隙综合征病例，该患者在复杂的代谢紊乱情况下出现亚急性、进行性下肢肌肉无力和疼痛。计算机断层扫描显示她左侧髂肌有一个自发性大血肿。尽管最初诊断延迟，但通过髂肌筋膜切开术成功治疗了她，症状完全缓解。
