Pigmenturia following direct muscle injury and delayed arterial reconstructive surgery. A case report

A case is presented with severe muscular trauma to the lower leg and ischaemia of nine hours duration secondary to a totally disrupted popliteal artery and vein. Following successful revascularisation and fasciotomies, the patient developed an extreme local muscular oedma, pigmenturia and impaired renal function. It is concluded that the pigmenturia was a mixture of both myoglobinuria and haematuria, dependent on an acute toxic nephrosis, due in part to rhabdomyolysis and in part to the effect of delayed revascularisation. Extensive fasciotomies completed at the time of revascularisation almost certainly attenuated the metabolic-toxic process to a large degree and contributed to the fair functional outcome.