Bilateral compartmental syndrome after prolonged surgery in the lithotomy position

Surgical procedures necessitating patient placement in physiologically abnormal positions can be associated with certain injuries usually arising from compression of nerves or muscles. Bilateral compartmental syndrome of the lower extremities is a grave complication, which, if unrecognized, can lead to either permanent neuromuscular dysfunction or limb loss. We report a case of bilateral four-compartment syndrome occurring after prolonged surgery with the patient in the lithotomy position.