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Case Reports
. 2013 Aug 9:2013:bcr2013010370.
doi: 10.1136/bcr-2013-010370.

Gluteal compartment syndrome with severe rhabdomyolysis

Nitisha Narayan  1 , Martin Griffiths, Hasu D L Patel
Affiliations
Case Reports

Gluteal compartment syndrome with severe rhabdomyolysis

Nitisha Narayan et al. BMJ Case Rep. .

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.

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Figures

Figure 1
Figure 1
Pressure ulcer on the right leg.
Figure 2
Figure 2
Preoperative image of the left buttock with tense swelling and skin changes.
Figure 3
Figure 3
Partial necrosis of gluteal maximus muscle.
Figure 4
Figure 4
Image taken after complete debridement.
Figure 5
Figure 5
Potassium trend from postperative days 1–8.
Figure 6
Figure 6
Creatine kinase trend from postoperative days 1–8.
Figure 7
Figure 7
(A) Kocher-Langenbach incision for gluteal fasciotomy. (B) The incision allows the identification of the sciatic nerve.
See this image and copyright information in PMC

References

    1. Köstler W, Strohm PC, Südkamp NP. Acute compartment syndrome of the limb. Injury 2004;2013:1221–7 - PubMed
    1. Taylor BC, Dimitris C, Tancevski A, et al. Gluteal compartment syndrome and superior gluteal artery injury as a result of simple hip dislocation: a case report. Iowa Orthop J 2011;2013:181–6 - PMC - PubMed
    1. Jagadesham VP, Mavor AID, Gough MJ. Unilateral gluteal compartment syndrome: a complication of open abdominal aortic aneurysm repair using an aortobifemoral bypass graft. Eur Soc Vasc Surg 2008;2013:14–16
    1. Iizuka S, Miura N, Fukushima T, et al. Gluteal compartment syndrome due to prolonged immobilization after alcohol intoxication: a case report. Tokai J Exp Clin Med 2011;2013:25–8 - PubMed

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