[Compartment syndrome in both lower legs after prolonged surgery in the lithotomy position]

A 35-year-old man developed bilateral compartment syndrome in the lower legs after prolonged colorectal surgery in the lithotomy position. This complication of a prolonged non-physiological operation position is a rare event and the diagnosis is therefore often delayed, with sometimes serious irreversible neuromuscular damage. In this case the complication was successfully treated by four-compartment fasciotomy and forced diuresis (to prevent renal insufficiency caused by myoglobin nephrosis).