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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
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Non-traumatic compartment syndrome secondary to deep vein thrombosis and anticoagulation

Peter Alexander Newman1, Sunny Deo

  • 1Department of General Surgery, North Bristol NHS Trust, Bristol, UK.

BMJ Case Reports
|January 21, 2014
PubMed

Insights

This case study highlights non-traumatic compartment syndrome in a patient treated with anticoagulation for deep vein thrombosis. Prompt fasciotomies were necessary due to high compartment pressures, with careful monitoring post-surgery.

Area of Science:

  • Vascular Surgery
  • Trauma Surgery
  • Medical Case Reports

Background:

  • Acute compartment syndrome (ACS) is a surgical emergency.
  • Non-traumatic etiologies are less common but critical to recognize.
  • Anticoagulation therapy can be a risk factor for ACS.

Observation:

  • A 57-year-old male inpatient developed ACS in three lower limb compartments.
  • The patient was recently initiated on anticoagulation for pulmonary emboli and deep vein thrombosis.
  • Compartment pressures exceeded 70 mm Hg, necessitating fasciotomies.

Findings:

  • Four-compartment fasciotomies were performed due to elevated pressures.
  • Postoperative heparin therapy led to significant blood loss but no neurovascular deficit.
  • Reoperation for wound closure revealed healthy tissue.

Implications:

  • This case underscores the importance of considering anticoagulation and deep venous thrombosis as non-traumatic causes of ACS.
  • Early recognition and surgical intervention are crucial for limb salvage.
  • Further research into the mechanisms linking anticoagulation to ACS may be warranted.

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