2016 Volume 36 Issue 3 Pages 280-285
A 52-year-old obese man was scheduled to undergo laparoscopic rectectomy. The operation was performed in the lithotomy position with the Trendelenburg position under general and epidural anesthesia for 6.5 hours, and was completed uneventfully. In the ICU, the patient complained of worsening pain in his left posterior calf and was diagnosed with acute compartment syndrome by high intra-compartmental pressure, 43 mmHg. The orthopedic consultants treated the patient with conservative therapy using analgesia and repeated assessment based on adequate perfusion pressure. The patient was discharged to the ward the next day. Rehabilitation was initiated from postoperative day 10 and led to temporal pain and paresthesia but was continued under careful repeated assessment. On postoperative day 49, the patient was discharged without complications. In acute compartment syndrome, early fasciotomy is important to avoid critical complications. However, the threshold for fasciotomy differs among surgeons. If conservative management is selected, the patient should be constantly assessed to reduce the chance of missing compartment syndrome.
