A case of severe compartment syndrome of the left lower limb after laparo-scopic anterior resection of rectal cancer

Kiminori Takano, Satoru Kikuchi, Yuta Abe, Tetsuo Ishizaki, Tetsuo Sumi, Motohide Shimazu

Research output: Contribution to journalArticle

Abstract

A 69-year-old man with rectal cancer underwent laparoscopic anterior resection of the rectum. The operative position was the lithotomy position with his head placed to the lower right in the Trendelenburg position. His lower legs were fixed with a supportive device. Postoperatively, he complained of left lower limb pain and severe swelling and tenderness were observed. On the first postoperative day there was more severe swelling in the left lower limb swelling and he experienced a slight motor and sensory disturbance of the dorsum of the foot. At first, we suspected deep venous thrombosis, but Doppler ultrasound examination was negative. Enhanced computed tomography revealed the left lower limb muscle to be massively swollen and edematous in the posterior compartment. Acute arterial occlusion and deep venous thrombosis were also not found. The serum creatine kinase value was 56,604 IU/L. The compartment pressure of the left gastrocnemius muscle was 110 inmHg. We diagnosed severe compartment syndrome of the left lower limb and performed fasciotomy via the double incision dorsal approach. The patient recovered, but slight sensory disturbance of the dorsum of the foot remained. Lower limb compartment syndrome after laparoscopic colorectal surgery in the lithotomy position is a rare but serious complication possibly resulting in severe sequelae. Laparoscopic surgeons should be aware of pre-ventative measures to reduce the incidence of lower limb compartment syndrome. However, if suspected, timely diagnosis and prompt fasciotomy are crucial for a favorable outcome.

Original languageEnglish
Pages (from-to)101-106
Number of pages6
JournalJapanese Journal of Gastroenterological Surgery
Volume45
Issue number1
DOIs
Publication statusPublished - 2012 Jan 21
Externally publishedYes

Fingerprint

Compartment Syndromes
Rectal Neoplasms
Lower Extremity
Venous Thrombosis
Foot
Head-Down Tilt
Doppler Ultrasonography
Colorectal Surgery
Creatine Kinase
Rectum
Laparoscopy
Leg
Skeletal Muscle
Head
Tomography
Pressure
Pain
Equipment and Supplies
Muscles
Incidence

Keywords

  • Compartment syndrome
  • Laparoscopic colorectal surgery

ASJC Scopus subject areas

  • Gastroenterology
  • Surgery

Cite this

A case of severe compartment syndrome of the left lower limb after laparo-scopic anterior resection of rectal cancer. / Takano, Kiminori; Kikuchi, Satoru; Abe, Yuta; Ishizaki, Tetsuo; Sumi, Tetsuo; Shimazu, Motohide.

In: Japanese Journal of Gastroenterological Surgery, Vol. 45, No. 1, 21.01.2012, p. 101-106.

Research output: Contribution to journalArticle

Takano, Kiminori ; Kikuchi, Satoru ; Abe, Yuta ; Ishizaki, Tetsuo ; Sumi, Tetsuo ; Shimazu, Motohide. / A case of severe compartment syndrome of the left lower limb after laparo-scopic anterior resection of rectal cancer. In: Japanese Journal of Gastroenterological Surgery. 2012 ; Vol. 45, No. 1. pp. 101-106.
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