Compartment syndrome associated with lithotomy position and intermittent compression stockings

Area of Science:

• Gynecology
• Surgical Complications
• Vascular Surgery

Background:

• Compartment syndrome is elevated tissue pressure compromising circulation within a confined space.
• Prolonged surgical procedures, particularly in the lithotomy position, pose risks for developing compartment syndrome.

Observation:

• A case report details a patient undergoing prolonged vesicovaginal fistula repair in the lithotomy position with sequential compression sleeves.
• Postoperatively, the patient developed acute leg and foot pain, leading to a compartment syndrome diagnosis.

Findings:

• Emergency fasciotomy was performed to treat the diagnosed compartment syndrome.
• The use of sequential compression sleeves during the prolonged procedure may have contributed to the increased risk.

Implications:

• Awareness of compartment syndrome is critical for gynecologists performing lengthy procedures in the lithotomy position.
• The combination of lithotomy position and compression devices may heighten the risk, necessitating vigilance.
• Prompt diagnosis and intervention are vital to mitigate long-term neurovascular morbidity associated with compartment syndrome.