We report a case of crush syndrome. A 60-year-old man crushed between the earth and construction equipment reported abdominal, chest, and low back pain and and dyspnea, evidencing spontaneous pain and tenderness without muscular rigidity in the abdomen. Plain chest X-ray and CT showed pneumothorax, hemothorax, and fractured ribs. Abdominal CT showed injury to the liver (Ia), kidney (Ib), and spleen (II) and the presence of ascites. He underwent endotracheal intubation for mechanical ventilation and bilateral chest drainage for pleural effusion and pneumothorax. Liver, spleen, and kidney damage was treated conservatively. His clinical symptoms resolved but muscular swelling from the buttocks to the femur and mioglobinemia occurred with simultaneously increased serum CPK, BUN, and Cr, K, yielding a diagnosis of crush syndrome. After hemodyalysis 9 times, his condition improved and he discharged after rehabilitation. Patients with crush syndrome require extensive transfusion and timely hemodyalysis to prevent multiple organ failure, including renal failure and rapidly progressive DIC.
