Abstract
A 72-year-old male was brought into our hospital for treatment of trauma induced by falling from a high place (about 4m in height). The patient's vital signs were stable and there were no external injuries. After admission, his blood pressure dropped suddenly. Massive left intrathoracic effusion was noted by a CT scan and a thoracic tube was inserted. The blood pressure returned to normal levels after the fluid resuscitation. On the next day, his urine output decreased and serum values of creatinine, potassium and creatinine kinase were elevated remarkably. The DIC score was also high. Intensive therapies including continuous hemodiafiltration (CHDF) were successfully performed under the diagnosis of acute renal failure induced by rhabdomyolysis and DIC, and he was discharged on the 46th hospital day.
Rhabdomyolysis may be due to many causes. Crush syndrome is the most common exogenous cause and single loading of external force rarely induces the disease like in this case. The patient was successfully treated by early diagnosis and appropriate treatments including CHDF. Care must be taken for rhabdomyolysis after the trauma of falling from a high place.
