Compartment syndrome associated with lithotomy position and intermittent compression stockings

Background: Compartment syndrome is a condition in which increased tissue p ressure within a limited tissue space compromises the circulation and funct ion of the contents of the space. Case: A 43-year-old black woman, para 3, had repair of a recurrent vesicova ginal fistula. She was placed in a low lithotomy position with thigh length sequential compression sleeves. The procedure lasted more than 5 hours. On postoperative day 1, she complained of pain in her right leg and foot. Com partment syndrome was diagnosed and emergency fasciotomy was done. Conclusion: Gynecologists should be aware of the possibility of compartment syndrome during prolonged procedures with patients in the lithotomy positi on. Concomitant intermittent compression sleeves might further increase the risk. Early diagnosis and treatment of compression syndrome are essential to minimize long-term neurovascular morbidity. (C) 2001 by The American Col lege of Obstetricians and Gynecologists.