Ebeling Mel, Hudson Blake
Department of Emergency Medicine University of Alabama at Birmingham Heersink School of Medicine Birmingham Alabama USA.
J Am Coll Emerg Physicians Open. 2024 Aug 5;5(4):e13270. doi: 10.1002/emp2.13270. eCollection 2024 Aug.
Acute compartment syndrome is a surgical emergency requiring rapid recognition in the emergency department to minimize morbidity and mortality. It is most commonly caused by traumatic extremity fractures, which account for about 75% of cases. Atraumatic acute compartment syndrome is substantially less common with current evidence mostly limited to case reports, and diagnosis is made more challenging by the absence of an obvious traumatic injury. We present the case of a young adult female patient with IgA vasculitis who developed recurrent, atraumatic acute compartment syndrome and was successfully managed with prompt fasciotomy. This is the first case of spontaneous intramuscular hemorrhage, a rare sequela of IgA vasculitis, leading to recurrent, atraumatic acute compartment syndrome. This case highlights the importance of both a thorough physical exam and maintaining a high suspicion for acute compartment syndrome in the absence of injury to ensure patients receive prompt surgical evaluation for definitive care.
急性骨筋膜室综合征是一种外科急症,需要在急诊科迅速识别,以尽量降低发病率和死亡率。它最常见的病因是四肢创伤性骨折,约占病例的75%。非创伤性急性骨筋膜室综合征则极为少见,目前的证据大多限于病例报告,且由于没有明显的创伤性损伤,诊断更具挑战性。我们报告一例患有IgA血管炎的年轻成年女性患者,她出现了复发性、非创伤性急性骨筋膜室综合征,并通过及时的筋膜切开术成功治疗。这是首例由IgA血管炎罕见后遗症——自发性肌肉内出血导致复发性、非创伤性急性骨筋膜室综合征的病例。该病例强调了全面体格检查的重要性,以及在无损伤情况下对急性骨筋膜室综合征保持高度怀疑的必要性,以确保患者能及时接受外科评估以获得确定性治疗。