| Compartment syndrome, fasciotomy, and neuropathy after a rattlesnake envenomation: aspects of monitoring and diagnosis. | |
| | |
MedLine Citation:
|
PMID: 16538944 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Compartment syndrome resulting from pitviper envenomation is uncommon in North America; however, when it does occur, early diagnosis, optimal antivenom therapy, and possible surgical decompression are the primary means of preventing the complication of neuropathy. Here, we report a case of a rattlesnake envenomation in the anterior compartment of the lower leg that required high doses of morphine to control pain. Although compartment syndrome was considered a possible outcome, subfascial pressures were not monitored and antivenom was discontinued at 24 hours. At 36 hours, the patient developed dorsal foot numbness and foot drop, and 15 hours later pressures within the anterior compartment were >68 mm Hg. Emergency fasciotomy was performed 59 hours postenvenomation. Peroneal neuropathy was evident after surgery and only partially recovered postoperatively. Earlier monitoring of subfascial pressures and using those pressures as a guide for decisions about time and dose of CroFab antivenom treatment may have permitted earlier surgical treatment after onset of compartment syndrome or even prevented the onset of this condition. |
| | |
Authors:
|
David L Hardy; Kelly R Zamudio |
Related Documents
:
|
8188774 - Compartment syndrome of the forearm and hand. 11311464 - Cauda equina syndrome. 17891694 - Abdominal compartment syndrome due to distended rectal stump. 1511794 - Tethered cord syndrome in myelodysplasia: correlation between level of lesion and heigh... 19894384 - Distribution and development of the tcm syndromes in psoriasis vulgaris. 9239954 - Congenital temporomandibular joint ankylosis--a case report. |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Wilderness & environmental medicine Volume: 17 ISSN: 1080-6032 ISO Abbreviation: Wilderness Environ Med Publication Date: 2006 |
Date Detail:
|
Created Date: 2006-03-16 Completed Date: 2006-06-08 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9505185 Medline TA: Wilderness Environ Med Country: United States |
Other Details:
|
Languages: eng Pagination: 36-40 Citation Subset: IM |
Affiliation:
|
dhardysr@therriver.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Animals Antivenins / therapeutic use* Compartment Syndromes / complications*, diagnosis, etiology, surgery* Crotalid Venoms / antagonists & inhibitors* Crotalus Decompression, Surgical Diagnosis, Differential Fascia / surgery* Female Humans Leg / blood supply Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Antivenins; 0/Crotalid Venoms |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Hypothermia with profound anemia and pancreatitis.
Next Document: The management of open fractures.