Compartment Syndrome Following Extravasation of Contrast: A Case Report

Acute compartment syndrome is a rare but serious complication of intravenous contrast extravasation, which can cause tissue ischemia and necrosis if not recognized and treated promptly. We report the case of a 56-year-old female with a history of breast cancer who developed acute compartment syndrome of the right hand and forearm after extravasation of approximately 20-30 mL of iodinated contrast agent administered via the dorsal hand during a CT scan. The patient presented with progressive swelling, pain disproportionate to injury, impaired digital perfusion, and limited mobility. Based on clinical findings, urgent surgical decompression via fasciotomy of the hand, wrist, and forearm compartments was performed with successful restoration of perfusion and function. Postoperative recovery was uneventful, although mild carpal tunnel syndrome developed on follow-up. This case highlights the importance of early recognition of intravenous contrast extravasation as a potential cause of acute compartment syndrome, especially in high-risk patients such as those with fragile veins, prior chemotherapy or obesity. Prompt diagnosis and immediate fasciotomy are crucial to prevent permanent functional impairment and severe morbidity. Awareness and vigilance among healthcare professionals administering contrast agents can improve patient outcomes through timely intervention.