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Case Reports
. 2022 Feb 6;10(4):1349-1356.
doi: 10.12998/wjcc.v10.i4.1349.

Fatal rhabdomyolysis and disseminated intravascular coagulation after total knee arthroplasty under spinal anesthesia: A case report

Dae Hun Yun  1 , Eun Ha Suk  2 , Wan Ju  1 , Eun Hyoung Seo  1 , Hyun Kang  1
Affiliations
Case Reports

Fatal rhabdomyolysis and disseminated intravascular coagulation after total knee arthroplasty under spinal anesthesia: A case report

Dae Hun Yun et al. World J Clin Cases. .

Abstract

Background: Rhabdomyolysis develops as a result of skeletal muscle cell collapse from leakage of the intracellular contents into circulation. In severe cases, it can be associated with acute kidney injury and disseminated intravascular coagulation, leading to life threatening outcomes. Rhabdomyolysis can occur in the perioperative period from various etiologies but is rarely induced by tourniquet use during orthopedic surgery.

Case summary: A 77-year-old male underwent right total knee arthroplasty using a tourniquet under spinal anesthesia. About 24 h after surgery, he was found in a drowsy mental state and manifested features of severe rhabdomyolysis, including fever, hypotension, oliguria, high creatine kinase, myoglobinuria, and disseminated intravascular coagulation. Despite supportive care, cardiac arrest developed abruptly, and the patient was not able to be resuscitated.

Conclusion: Severe rhabdomyolysis and disseminated intravascular coagulation can develop from surgical tourniquet, requiring prompt, aggressive treatments to save the patient.

Keywords: Case report; Disseminated intravascular coagulation; Rhabdomyolysis; Total knee arthroplasty; Tourniquet.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Changes in vital signs during the operation. DBP: Diastolic blood pressure; HR: Heart rate; SBP: Systolic blood pressure.
See this image and copyright information in PMC

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