2018 Volume 51 Issue 6 Pages 401-408
A 77-year-old female with dementia and depression was housed in a nursing home. When a member of staff visited her room in the early morning, no abnormalities were observed. An hour later, a member of staff found that she had partially fallen from her bed, and her head was touching the floor, her lower abdomen was pressed against the bed rails (which had overturned), while her lower body remained on the bed. After being rescued, she could not move her lower limbs, and renal dysfunction and hyperkalemia were observed the next day. So, she was admitted to our hospital. Based on the circumstances of the incident and various findings, we diagnosed her with acute kidney failure and disseminated intravascular coagulation (DIC) due to crush syndrome. We performed hemodialysis on the same day because anuria persisted despite massive fluid replacement. After three dialysis sessions, the patient’s renal function was restored. Then, dialysis was discontinued, and her DIC symptoms and lower limb motor function subsequently also improved. Crush syndrome is often seen after a disaster or traffic accident, when part of the body has been under pressure for a long period of time. However, it can occur in daily life, and it has also been observed in cases of emaciated or elderly people, in whom it can develop after short periods of pressure exposure. Crush syndrome is a serious condition, which often becomes life-threatening if it is not diagnosed. Knowledge of the patient’s history of recent injuries is important for diagnosing crush syndrome.
