Yang Victor B, Shu Henry, Shah Manuj M, Zhao Xiyu, Muquit Siam T, Greenberg Marc, Whitman Glenn, Cho Sung-Min, Kim Bo Soo, Shafiq Babar
Critical Care, Johns Hopkins University School of Medicine, Baltimore, USA.
Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, USA.
Cureus. 2023 Sep 1;15(9):e44519. doi: 10.7759/cureus.44519. eCollection 2023 Sep.
We report the case of a 53-year-old male who developed polycompartment syndrome (PCS) secondary to cardiogenic shock. After suffering a cardiac arrest, a self-perpetuating cycle of intra-abdominal hypertension (IAH) and vital organ damage led to abdominal compartment syndrome (AbCS), which then contributed to the precipitation of extremity compartment syndrome (CS) in bilateral thighs, legs, forearms, and hands. This report is followed by a review of the literature regarding the pathophysiology of this rare sequela of cardiogenic shock. While the progression from cardiogenic shock to AbCS and ultimately to PCS has been hypothesized, no prior case reports demonstrate this. Furthermore, this case suggests more generally that IAH may be a risk factor for extremity CS. Future studies should examine the potential interplay between IAH and extremity CS in patients at risk, such as polytrauma patients with tibial fractures.
我们报告了一例53岁男性患者，其因心源性休克继发多腔隙综合征（PCS）。在心脏骤停后，腹内高压（IAH）和重要器官损伤的自我持续循环导致了腹腔间隔室综合征（AbCS），进而促使双侧大腿、小腿、前臂和手部发生肢体间隔室综合征（CS）。本报告之后是对关于心源性休克这一罕见后遗症病理生理学的文献综述。虽然已经推测了从心源性休克到AbCS并最终到PCS的进展过程，但此前尚无病例报告证实这一点。此外，该病例更普遍地表明IAH可能是肢体CS的一个危险因素。未来的研究应探讨IAH与处于危险中的患者（如伴有胫骨骨折的多发伤患者）肢体CS之间的潜在相互作用。
