UNASSIGNED: Snake bites pose a significant common public health concern, with more prevalence in rural areas. Compartment syndrome (CS) is one of the rare and severe manifestations of snake bite wherein venom-induced swelling within a closed anatomical compartment leads to increased pressure, which may result in ischemic damage to nerves and muscle. Antisnake venom and prompt fasciotomy is recommended for management of CS secondary to snake bite.
UNASSIGNED: Here, the authors report a case of 47-year-old female with Green Pit Viper bite on the left hand. Upon arrival to hospital, initial resuscitation measures were initiated. Six hours following the bite, there was severe pain on passive stretch and paresthesia. Ten vials of antisnake venom administration along with fasciotomy of hand and arm resulted in notable alleviation of pain and swelling. Eighteen pints of blood was transfused for coagulopathy and low hemoglobin. After continued care of wound and intensive physiotherapy, functional limb could be achieved.
UNASSIGNED: Snake bite envenomation is one of the biggest hidden health crises with case fatality rate of 7.8% in the southern plains of Nepal. As in our case, snake bites commonly affect upper extremities, accounting for around two third of all cases. CS must be differentiated from acute swelling, which sometimes may be difficult. Surgical decompression is indicated in presence of signs and symptoms of CS, in case of resource limited setting.
UNASSIGNED: Multidisciplinary and prompt management with initial resuscitation, ASV administration, fasciotomy, and rehabilitative measures can save both life and limb in such cases.

Compartment syndrome is a rare critical condition that can arise in individuals with cancer, presenting with significant challenges in diagnosis and management. Compartment syndrome occurs when the pressure within a closed fascial space rises to a point that restricts circulation. A 56 year-old male patient presented with 2 days of pain and swelling in the right upper extremity pain. Physical examination was remarkable for right upper extremity erythema swelling and tense compartments, concerning for compartment syndrome. Humerus X-ray showed moth eaten appearance of mid humerus with periosteal reaction and fracture. Patient was taken to the operating room for anterior and posterior compartment fasciotomies. Compartment syndrome is a surgical emergency, for which fasciotomy is generally performed. Pathology has rarely been linked to malignancy, with seldom reports examining causation. More research regarding pathophysiology of cancer in relation to compartment syndrome needs to be conducted.

BACKGROUND: Compartment syndrome commonly occurs in patients with forearm and lower leg fractures. Compartment syndromes of the gluteal and thigh muscles are less common. It is imperative that compartment syndrome be diagnosed and treated with fasciotomy as soon as possible. However, there are few reports on the diagnosis and treatment strategies for compartment syndromes that occur simultaneously in multiple anatomical regions or in the ipsilateral gluteal region and thigh.
METHODS: We report on a 76-year-old man who was obliquely crushed under a tree extending from the right forearm to the left groin. He was brought to our emergency room, where he was diagnosed with compartment syndrome of the right forearm and left lower leg and crush syndrome. Emergency fasciotomy was performed. On the day after admission, swelling and tightness of the left gluteal thigh became apparent, and intracompartmental pressures were elevated, which led to an additional diagnosis of these compartment syndromes. A fasciotomy was performed, the gluteal skin incision was made according to the Kocher-Langenbeck approach (one of the posterior approaches for hip fractures), and the thigh was approached by extending the incision laterally. This surgical approach enabled the decompression of the compartments through a single incision and allowed for easier wound treatment and closure.
CONCLUSIONS: This case highlights the diagnosis and treatment of compartment syndrome in four anatomical regions. Extension of the Kocher-Langenbeck approach to the lateral thigh can be a useful surgical approach for ipsilateral gluteal and thigh compartment syndrome.

Paraspinal compartment syndrome is a rare and potentially life-threatening condition. Diagnosis and treatment are often delayed due to a broad differential for back pain, from musculoskeletal to abdominal etiologies. Diagnosis is made with difficulty through clinical picture, laboratory values representative of rhabdomyolysis, advanced imaging, and compartment pressure measurements. Unfortunately, this diagnosis is late; therefore, risks of significant morbidity increase. The mainstay of treatment is emergent fasciotomy of the paraspinal muscles and medical management of rhabdomyolysis. The majority of patients return to baseline functional strength and full range of motion after early treatment. We present a case of severe bilateral paraspinal compartment syndrome that resulted in excisional debridement of necrotic muscle, acute kidney injury, and ileus.

BACKGROUND: Acute compartment syndrome following a transradial coronary approach is rare. However, as the incidence of coronary arterial disease increases due to lifestyle factors and multiple comorbidities, transradial coronary angiography has become more common for diagnostic and therapeutic purposes in cardiovascular centers. Despite its rarity, we encountered two cases of acute compartment syndrome within a 1-week interval in the cardiology unit of a tertiary hospital.
METHODS: The first case involved a 75-year-old woman diagnosed with non-ST elevation myocardial infarction (NSTEMI). A coronary angiogram was performed via an uncomplicated right radial artery puncture. Following the procedure, the patient experienced significant swelling in the right forearm. An emergency fasciotomy release of the right forearm was conducted, revealing a gushing hematoma upon entering the flexor compartment. Fortunately, the wound healed well two months postoperatively with no functional deficits. In the second case, an 80-year-old man presented with severe angina pectoris upon exertion and was diagnosed with NSTEMI. The following day, he developed compartment syndrome in the left forearm, necessitating an emergency fasciotomy. Intraoperative examination revealed muscle bulging within the forearm compartments accompanied by extensive hematoma. Postoperatively, a deranged coagulation profile caused oozing from the wound. However, since there was no arterial bleeding, a compression dressing was applied. This led to a gradual drop in hemoglobin levels and worsened his heart condition. Despite resuscitative efforts and attempts to correct the coagulopathy, the patient experienced cardiorespiratory arrest and succumbed to ischemic heart disease in failure.
CONCLUSIONS: Clinicians must remain vigilant in identifying this potentially limb-threatening condition. Patients with pre-existing anticoagulant therapy and underlying atherosclerotic disease are at a higher risk of bleeding complications. Implementing effective hemostasis techniques and promptly managing swelling can help prevent the occurrence of compartment syndrome. Timely assessment and maintaining a high level of clinical suspicion are paramount. If necessary, early consideration of decompressive fasciotomy is essential to avert catastrophic outcomes.

BACKGROUND: Bites caused by European vipers are rare medical emergencies but can occasionally cause life-threatening complications. Viper venom causes local symptoms, which can be accompanied by systemic manifestations in severe cases. The local effects of snakebites include edema and, more rarely, necrosis and compartment syndrome. The consequences of envenomation are often more pronounced in children due to their smaller body size.
METHODS: We present the case of a 6-year-old girl who experienced multiple viper bites in the lower limb in northwest Italy. The girl received supportive care but progressed to develop compartment syndrome that required emergency fasciotomy. The patient\'s condition improved promptly after surgical decompression and administration of antivenom, but full recovery required prolonged hospitalization and rehabilitation.
CONCLUSIONS: This case highlights the importance of obtaining a timely assessment of the severity of viper envenomation without delaying the administration of antivenom in most serious cases. The presence of multiple bite marks on the patient is one factor that may help to predict the clinical severity of snakebites and anticipate symptom progression.

While fasciotomy is the only urgent treatment option for compartment syndrome, the resulting open wound leaves room for complications. Closure of the wound can be done by different techniques, including split-thickness skin grafts, negative pressure therapy, an absorbable barbed suture system and a cable ties system. The aim of this paper is to demonstrate how a combined application of these methods can reduce their respective individual disadvantages. Our combined method was tried in two patients, one with an open tibial fracture and the other who underwent ulnar nerve reparation. Both patients started exhibiting signs of compartment syndrome within 3 hrs after surgery. Firstly, absorbable barbed suture systems were positioned with the running intradermal technique. Following this the cable ties were inserted and the limb in question was placed in an elevated position. Complete closure of the patient\'s wounds was achieved within 2 weeks without complications. This result is a testament to the added benefit of a combination of these methods in comparison with the results they produce individually.

UNASSIGNED: Acute exertional compartment syndrome (AECS) is a condition with the potential for devastating outcomes if not promptly treated. Physicians must maintain a high index of suspicion when evaluating patients presenting with pain, swelling, decreased range of motion, and numbness within a muscle compartment. However, AECS is frequently misdiagnosed due to a multitude of factors, leading to a delay in treatment. In this case report, we would like to shed light on a rare case of bilateral upper-extremity AECS and suggest the treatment paradigm we believe will help prevent negative outcomes.
UNASSIGNED: A previously healthy 33-year-old male presented with bilateral weakness, tingling, tenderness, swelling, and pain upon movement in the trapezius and deltoid muscles. The symptoms started after he performed \"burpees\" for 18 h following a 12-h forest-fire firefighting shift. The patient\'s rapidly developing clinical presentation warranted compartmental pressure checks for suspicion of AECS. Being able to quickly determine the elevated trapezius, deltoid, and supraspinatus compartmental pressures allowed us to perform immediate bilateral fasciotomies with delayed primary closure to relieve compartment pressure.
UNASSIGNED: The delay in treatment for patients presenting with AECS is multifactorial and may lead to devastating outcomes if not promptly addressed. The lack of literature regarding bilateral upper-extremity AECS makes the treatment for this condition even more difficult. For our patient, having a proper criterion for performing compartmental pressure checks played a vital role in ensuring an accurate diagnosis and timely medical intervention.

BACKGROUND: Acute foot compartment syndrome (FCS) is a rare but potentially devastating complication that can occur following severe trauma of the limbs. In very are cases, such syndrome occurs following minor trauma. We present an exceptional case of acute FCS as a complication of an ankle sprain.
RESULTS: A 32-year-old male patient presented with excruciating foot pain and swelling 48 hours following an ankle sprain. Physical examination revealed severe swelling of the right foot, pale and swollen toes, and tense and pale dorsal skin and severe pain upon passive extension of the toes.
METHODS: An acute FCS was considered.
RESULTS: The patient underwent a fasciotomy using a double-dorsal incision technique. The patient\'s symptoms were controlled, and he was discharged from the hospital 2 days after the surgery.
CONCLUSIONS: Acute FCS could occur following minor trauma such as an ankle sprain. Early recognition and timely surgical intervention are crucial to prevent severe complications. The diagnosis is primarily clinical and immediate fasciotomy is needed to reduce intracompartment pressure and prevent muscular necrosis and other complications.

BACKGROUND: Clinical attempts of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) have increased in recent years; however, it also has life-threatening complications. Massive fluid and transfusion resuscitation, shock status, or low cardiac output status during ECPR may lead to ascites and interstitial edema, resulting in secondary abdominal compartment syndrome (ACS).
METHODS: A 43-year-old male patient was admitted to the emergency department due to cardiac arrest. Due to refractory ventricular fibrillation, ECPR was initiated. Approximately, 3 h after extracorporeal membrane oxygenation support, abdominal distension and rigidity developed. Therefore, ACS was suspected. Decompression laparotomy was required to relieve elevated intra-abdominal pressure.
CONCLUSIONS: We report a case of a patient with OHCA who developed lethal ACS after ECPR. Despite this, the patient was able to recover from several major crises. Regardless of how lethal the patient is, if compartment syndrome develops in any part of the body, we should aggressively consider surgical decompression.