A 61-year-old man was admitted to a local hospital for consciousness disorder, hypotension and monoplegia of the left leg. Before admission, he had remained asleep on an electric carpet for 17 hours after drinking beer and whiskey. Although his consciousness disorder and hypotension improved, he was transferred to our hospital 6 days after the injury because of oligouria. Examination revealed pain and swelling of the left buttock and left sciatic palsy. Laboratory data showed azotemia and elevated serum CPK, GOT, LDH, and myoglobin levels. CT and MRI demonstrated damage to the left gluteal muscles. A tentative diagnosis of non-traumatic rhabdomyolysis of the left gluteal region complicated by acute renal failure with left sciatic palsy was made. The patient remained oligouric despite treatment with fluid challenge and diuretics. Hemodialysis was started on the second day after admission. Renal function recovered completely after hemodialysis 6 times in 8 days, but necrosis and atrophy of the left gluteal muscles developed, and the left sciatic palsy persisted. This case represents a gluteal compartment syndrome caused by prolonged coma due to alcohol abuse. The compartment syndrome is a serious complication of non-traumatic rhabdomyolysis. Early diagnosis and rapid decompression of the affected area by fasciotomy are important to a good functional prognosis.
