Gluteal compartment syndrome with severe rhabdomyolysis

Abstract

Gluteal compartment syndrome is a rare entity but a recognised complication of prolonged immobilisation. It can present as renal failure as a result of severe rhabdomyolysis and can lead to sepsis and death. We report a case of gluteal compartment syndrome in a 25-year-old man who was found unconscious following intoxication with alcohol and cocaine of an unknown duration. He presented with tense tight left buttock swelling, right thigh swelling, cold immobile extremeties and acute renal failure. Immediate left gluteal, thigh and calf fasciotomy resulting in an improvement of lower limb and renal function.

Figure 1

Pressure ulcer on the right leg.

Figure 2

Preoperative image of the left buttock with tense swelling and skin changes.

Figure 3

Partial necrosis of gluteal maximus muscle.

Figure 4

Image taken after complete debridement.

Figure 5

Potassium trend from postperative days 1–8.

Figure 6

Creatine kinase trend from postoperative days 1–8.

Figure 7

(A) Kocher-Langenbach incision for gluteal fasciotomy. (B) The incision allows the identification of the sciatic nerve.