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Torture rhabdomyorhexis--a pseudo-crush syndrome
1Department of General Surgery, Hadassah University Hospital, Jerusalem, Israel.
The Journal of Trauma
|February 1, 1995
Summary
This study describes a pseudo-crush syndrome in two patients experiencing torture and dehydration, leading to acute renal failure due to muscle injury and myoglobinuria. The findings highlight an unusual cause of rhabdomyolysis and renal damage.
Area of Science:
- Nephrology
- Toxicology
- Trauma Medicine
Background:
- Acute renal failure (ARF) can result from various insults, including crush syndrome.
- Understanding novel etiologies of ARF is crucial for effective clinical management.
Observation:
- Two patients presented with ARF following systematic torture and prolonged deprivation of oral intake.
- Clinical presentation mimicked crush syndrome but stemmed from direct blunt muscle trauma (rhabdomyorhexis) and forced dehydration.
Findings:
- The combination of rhabdomyolysis and dehydration precipitated myoglobinuria, leading to ARF.
- Biochemical markers for injury severity, pathophysiology, and a management protocol are detailed.
Implications:
- This case series expands the differential diagnosis of ARF, particularly in contexts of severe trauma and deprivation.
- Recognizing this pseudo-crush syndrome is vital for timely and appropriate medical intervention in similar clinical scenarios.