A Case of Well Leg Compartment Syndrome that Developed after Total Pelvic Exenteration without Sequelae due to Early Intervention

Abstract

A 65-year-old man underwent laparoscopic total pelvic exenteration for advanced rectal cancer. Postoperative blood tests showed markedly elevated CPK levels and bilateral leg pain, and examination showed erythema, swelling, heat, and marked tenderness of both lower legs. Intrafascial pressures were measured and found to be elevated bilaterally. The patient was diagnosed as having bilateral leg compartment syndrome due to the surgical position. A tension reduction incision was performed on the medial side of both lower legs at 14.5 hours postoperatively ; the pain was relieved, and the CPK level decreased. On the 14th postoperative day, the tension-reducing incisions were closed, and after rehabilitation, the patient was discharged home with almost no sequelae 3 months after the surgery. Leg compartment syndrome, which develops in a healthy lower limb due to surgical positioning or prolonged surgery, is a potentially fatal condition if therapeutic intervention is delayed. When lower limb pain and elevated CPK levels are observed after low head surgery or prolonged surgery, lower leg compartment syndrome should be considered, and early intervention is necessary.