Compartment Syndromes ; diagnosis ; etiology ; therapy ; Humans ; Pancreatitis, Acute Necrotizing ; complications

Adult ; Compartment Syndromes ; etiology ; Hemophilia A ; complications ; Humans ; Leg ; Male

Ankle Injuries ; complications ; Compartment Syndromes ; etiology ; Female ; Fractures, Bone ; complications ; Humans ; Joint Dislocations ; complications ; Middle Aged

Adult ; Aneurysm, Dissecting ; complications ; Aortic Aneurysm, Thoracic ; complications ; Compartment Syndromes ; complications ; Humans ; Male

Compartment Syndromes ; etiology ; Crush Syndrome ; complications ; Fascia ; Hand Injuries ; complications ; Humans ; Infant, Newborn

PURPOSE: Liver is the most frequently injured organ in abdominal trauma. Today non-operative management (NOM) is considered as the standard of care in hemodynamically stable patients, with or without the adjunct of angioembolisation (AE). This systematic review assesses the incidence of complications in patients who sustained liver injuries and were treated with simple clinical observation. Given the differences in indications of treatment and severity of liver trauma and acknowledging the limitations of this study, an analysis of the results has been done in reference to the complications in patients who were treated with AE. METHODS: A systematic literature review searched "liver trauma", "hepatic trauma", "conservative management", "non operative management" on MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials databases, EMBASE, and Google Scholar, to identify studies published on the conservative management of traumatic liver injuries between January 1990 and June 2020. Patients with traumatic liver injuries (blunt and penetrating) treated by NOM, described at least one outcome of interests and provided morbidity outcomes from NOM were included in this study. Studies reported the outcome of NOM without separating liver from other solid organs; studies reported NOM complications together with those post-intervention; case reports; studies including less than 5 cases; studies not written in English; and studies including patients who had NOM with AE as primary management were excluded. Efficacy of NOM and overall morbidity and mortality were assessed, the specific causes of morbidity were investigated, and the American Association for the Surgery of Trauma classification was used in all the studies analysed. Statistical significance has been calculated using the Chi-square test. RESULTS: A total of 19 studies qualified for inclusion criteria were in this review. The NOM success rate ranged from 85% to 99%. The most commonly reported complications were hepatic collection (3.1%), followed by bile leak (1.5%), with variability between the studies. Other complications included hepatic haematoma, bleeding, fistula, pseudoaneurysm, compartment syndrome, peritonitis, and gallbladder ischemia, all with an incidence below 1%. CONCLUSION NOM with simple clinical observation showed an overall low incidence of complications, but higher for bile leak and collections. In patients with grade III and above injuries, the incidence of bile leak, collections and compartment syndrome did not show a statistically significant difference with the AE group. However, the latter result is limited by the small number of studies available and it requires further investigations.
Abdominal Injuries/complications* ; Compartment Syndromes ; Humans ; Injury Severity Score ; Liver/injuries* ; Retrospective Studies ; Wounds, Nonpenetrating/complications*

Presented in this paper is our experience in the diagnosis and management of abdominal compartment syndrome during severe acute pancreatitis. On the basis of the history of severe acute pancreatitis, after effective fluid resuscitation, if patients developed renal, pulmonary and cardiac insufficiency after abdominal expansion and abdominal wall tension, ACS should be considered. Cystometry could be performed to confirm the diagnosis. Emergency decompressive celiotomy and temporary abdominal closure with a 3 liter sterile plastic bag must be performed. It is also critical to prevent reperfusion syndrome. In 23 cases of ACS, 18 cases received emergency decompressive celiotomy and 5 cases did not. In the former, 3 patients died (16.7%) while in the later, 4 (80%) died. Total mortality rate was 33.3% (7/21). In 7 death cases, 4 patients developed acute obstructive suppurative cholangitis (AOSC). All the patients who received emergency decompressive celiotomy 5 h after confirmation of ACS survived. The definitive abdominal closure took place mostly 3 to 5 days after emergency decompressive celiotomy, with longest time being 8 days. 6 cases of ACS at infection stage were all attributed to infected necrosis in abdominal cavity and retroperitoneum. ACS could occur in SIRS stage and infection stage during SAP, and has different pathophysiological basis. Early diagnosis, emergency decompressive celiotomy and temporary abdominal closure with a 3L sterile plastic bag are the keys to the management of the condition.
*Abdomen ; *Compartment Syndromes/diagnosis ; *Compartment Syndromes/etiology ; *Compartment Syndromes/surgery ; Decompression, Surgical ; *Multiple Organ Failure/diagnosis ; *Multiple Organ Failure/etiology ; *Multiple Organ Failure/surgery ; *Pancreatitis, Acute Necrotizing/complications ; *Pancreatitis, Acute Necrotizing/diagnosis ; *Pancreatitis, Acute Necrotizing/surgery

Gunshot injuries are getting more frequently reported while the civilian (nongovernmental) armament increases in the world. A 42-year-old male patient presented to emergency room of Istanbul Medipol University Hospital due to a low-velocity gunshot injury. We detected one entry point on the posterior aspect of the thigh, just superior to the popliteal groove. No exit wound was detected on his physical examination. There was swelling around the knee and range of motion was limited due to pain and swelling. Neurological and vascular examinations were intact. Following the initial assessment, the vascular examination was confirmed by doppler ultrasonography of the related extremity. There were no signs of compartment syndrome in the preoperative physical examination. A bullet was detected in the knee joint on the initial X-rays. Immediately after releasing the tourniquet, swelling of the anterolateral compartment of the leg and pulse deficiency was detected on foot in the dorsalis pedis artery. Although the arthroscopic removal of intra-articular bullets following gunshot injuries seems to have low morbidity rates, it should always be considered that the articular capsule may have been ruptured and the fluids used during the operation may leak into surrounding tissues and result in compartment syndrome.
Adult ; Arthroscopy/*adverse effects ; *Compartment Syndromes ; Humans ; Knee Injuries/*surgery ; Male ; *Postoperative Complications ; Turkey ; *Wounds, Gunshot

Since we called for the attention of the occurrence of abdominal compartment syndrome in 2002, forty cases of this complication have been recognized and reported by six burn units in this journal, including three cases accompanied with massive pleural effusion (1601 - 3240 mL). Most cases emerged after "aggressive" fluid resuscitation, especially after massive infusion of crystalloid fluid. The idea "more fluid no harm" should be corrected. The goal of early fluid resuscitation in burn is to correct the hypovolemia and cell hypoxia, and circulating fluid just serves as a carrier in bringing O2 to the cells and carrying out CO2 and other metabolites from tissues. In face of "leaking while infusing", heavy accumulation of fluid in the third spaces may worsen the cell hypoxia. Some of the parameters we get from invasive monitoring systems can be misleading. Now, the trend of overloading should be prevented, and it behaves us to study the regime of lower fluid volume with proper contents in burn shock resuscitation.
Abdominal Cavity ; Burns ; complications ; therapy ; Compartment Syndromes ; etiology ; therapy ; Fluid Therapy ; Humans

Compartment syndrome after an adder bite is extremely rare, whose effects are only secondary to the cytotoxic and hemorrhagic effects of venom. Here we reported a case of compartment syndrome in the upper limb following an adder bite in the thenar eminence. Elevated compartment pressure was documented and immediate surgical fasciotomy was practiced. The patient achieved complete recovery with a good functional result. We discussed the controversies on fasciotomy and non-invasive measures in such a situation, and recommended intracompartmental pressure monitoring during the management of compartment syndrome following adder bites.
Adult ; Animals ; Compartment Syndromes ; etiology ; Humans ; Male ; Snake Bites ; complications ; Upper Extremity ; Viperidae