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COMPARTMENT SYNDROME ASSOCIATED WITH LITHOTOMY POSITION AND INTERMITTENT COMPRESSION STOCKINGS

Cohen, Stephen A. MD; Hurt, W. Glenn MD

CASE REPORTS
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Background Compartment syndrome is a condition in which increased tissue pressure within a limited tissue space compromises the circulation and function of the contents of the space.

Case A 43-year-old black woman, para 3, had repair of a recurrent vesicovaginal fistula. She was placed in a low lithotomy position with thigh length sequential compression sleeves. The procedure lasted more than 5 hours. On postoperative day 1, she complained of pain in her right leg and foot. Compartment syndrome was diagnosed and emergency fasciotomy was done.

Conclusion Gynecologists should be aware of the possibility of compartment syndrome during prolonged procedures with patients in the lithotomy position. Concomitant intermittent compression sleeves might further increase the risk. Early diagnosis and treatment of compression syndrome are essential to minimize long-term neurovascular morbidity.

Concomitant intermittent compression sleeves might increase the risk of compartment syndrome further during prolonged procedures with patients in the lithotomy position.

Department of Obstetrics and Gynecology, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia.

Address reprint requests to: Stephen A. Cohen, MD, Department of Obstetrics and Gynecology, Virginia Commonwealth University, Medical College of Virginia Hospitals, PO Box 980034, Richmond, VA 23298-0034. E-mail: stcohen@hsc.vcu.edu

Received August 7, 2000. Received in revised form October 10, 2000. Accepted October 26, 2000.

© 2001 The American College of Obstetricians and Gynecologists