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造影剂外渗继发手部骨筋膜室综合征:一例报告

Hand compartment syndrome secondary to contrast media extravasation: A case report.

作者信息

Diop Badara, Soh Guillaume Tcheutchoua, Nde Armel Franck Tene, Sarr Ndiamé, Ndoye Abdou Yacine, Sane Jean Claude

机构信息

Department of Surgery, Gaston Berger University, Saint-Louis, Senegal.

Department of Surgery, Gaston Berger University, Saint-Louis, Senegal.

出版信息

Int J Surg Case Rep. 2022 Sep;98:107595. doi: 10.1016/j.ijscr.2022.107595. Epub 2022 Sep 2.

Abstract

INTRODUCTION

Contrast media extravasation injury is a recognized complication of contrast media use. Compartmental syndrome of the hand secondary to contrast extravasation is exceptional. We describe a case of compartment syndrome of the hand secondary to contrast media extravasation.

CASE PRESENTATION

We present a 47-year-old woman with a history of pulmonary embolism who was diagnosed of compartment syndrome of the left hand after injection of contrast medium during a CT scan. Whose first diagnosis was mild contrast medium extravasation injury 24 h before the compartment syndrome. Standard radiography showed an accumulation of contrast medium in the left hand. The patient underwent a fasciotomy and secondary healing. Follow-up showed good radiographic, clinical, and hand function after 2 months.

DISCUSSION

The occurrence of hand compartment syndrome secondary to contrast media extravasation is rare. Most of the time, they are initially diagnosed as medium extravasation before the worsening of symptoms. Because of its unknown incidence, treatment is not codified. The goal of treatment is to save the limb and restore function. This can be achieved rapidly with early surgery because of the unpredictable course.

CONCLUSION

Contrast media injection is not a harmless gesture. Hand compartment syndrome after contrast extravasation is rare and is a severe injury, our experience with this case suggests that early surgery helps save the limb and restore function. Always fear a compartmental syndrome in case of extravasation of contrast medium.

摘要

引言

造影剂外渗损伤是使用造影剂时公认的并发症。造影剂外渗继发手部骨筋膜室综合征极为罕见。我们报告一例造影剂外渗继发手部骨筋膜室综合征的病例。

病例介绍

我们报告一名47岁有肺栓塞病史的女性,在CT扫描期间注射造影剂后被诊断为左手骨筋膜室综合征。在骨筋膜室综合征出现前24小时,其最初诊断为轻度造影剂外渗损伤。标准X线片显示左手有造影剂积聚。患者接受了筋膜切开术及二期愈合。随访显示2个月后影像学、临床及手部功能恢复良好。

讨论

造影剂外渗继发手部骨筋膜室综合征的情况罕见。大多数情况下,在症状恶化前,它们最初被诊断为造影剂外渗。由于其发病率未知,治疗方法未被规范。治疗的目标是挽救肢体并恢复功能。由于病情发展不可预测,早期手术可迅速实现这一目标。

结论

注射造影剂并非无害操作。造影剂外渗后手部骨筋膜室综合征罕见但为严重损伤,我们对此病例的经验表明早期手术有助于挽救肢体并恢复功能。一旦发生造影剂外渗,应始终警惕骨筋膜室综合征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed2a/9482983/f73b57227827/gr1.jpg

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