Tanabe Maki, Hikone Mayu, Sugiyama Kazuhiro, Hamabe Yuichi
Tertiary Emergency Medical Center (Trauma and Critical Center) Tokyo Metropolitan Bokutoh Hospital Tokyo Japan.
Department of Emergency Medicine (Tokyo Emergency Room of Bokutoh) Tokyo Metropolitan Bokutoh Hospital Tokyo Japan.
Acute Med Surg. 2022 May 16;9(1):e756. doi: 10.1002/ams2.756. eCollection 2022 Jan-Dec.
Limb compartment syndrome (LCS), a rare but serious complication of systemic capillary leak syndrome (SCLS)-related systemic edema, warrants prompt decompressive fasciotomy. We report a case of SCLS complicated by LCS of four extremities requiring emergent fasciotomies; furthermore, we reviewed existing published reports on SCLS with LCS.
A 36-year-old man was diagnosed with SCLS based on profound vascular permeability with no other underlying conditions. Within a few hours of admission, LCS was noted in the patient's lower legs and thighs and he was treated using decompressive fasciotomy. Additional forearm fasciotomy was subsequently carried out. After fluid management, vasopressor support, mechanical ventilation, and renal replacement therapy, the patient was discharged without any neuromuscular deficits caused by LCS. Literature review suggested that lower legs are prone to LCS in patients with SCLS.
Limb compartment syndrome is a serious complication that clinicians must be aware of and requires prompt decompressive fasciotomy.
肢体骨筋膜室综合征（LCS）是系统性毛细血管渗漏综合征（SCLS）相关全身性水肿的一种罕见但严重的并发症，需要及时进行减压筋膜切开术。我们报告一例SCLS合并四肢LCS并需要紧急筋膜切开术的病例；此外，我们回顾了已发表的有关SCLS合并LCS的报告。
一名36岁男性因严重血管通透性且无其他基础疾病而被诊断为SCLS。入院后数小时内，患者小腿和大腿出现LCS，并接受了减压筋膜切开术治疗。随后又进行了前臂筋膜切开术。经过液体管理、血管活性药物支持、机械通气和肾脏替代治疗后，患者出院，未出现由LCS引起的任何神经肌肉功能缺损。文献回顾表明，SCLS患者的小腿易发生LCS。
肢体骨筋膜室综合征是一种严重的并发症，临床医生必须予以关注，并需要及时进行减压筋膜切开术。
