A Case of Compartment Syndrome after Prolonged Lithotomy Position

Abstract

  A 51-year-old man was scheduled for laparoscopic rectectomy. He ran marathons and his lower limbs were muscular. After induction of general anesthesia, the patient was maintained at lithotomy position with Trendelenburg. During the operation, which lasted about ten hours, the hemodynamic parameters of the patient were stable. After awaking, the patient complained of pain in his left calf. On the day after the operation, the patient was diagnosed with compartment syndrome, so a fasciotomy was immediately performed. The patient suffered from nociceptive pain and neuropathic pain, but four months later he was able to walk by himself and left the hospital. In this case, the main cause of compartment syndrome appeared to be prolonged lithotomy position with Trendelenburg. In the case of lithotomy position for a long period, the patient should be managed keeping the risk of compartment syndrome in consideration.