A condition known as compartment syndrome occurs when excessive pressure builds up within a closed muscle space in the body. This condition is usually caused by bleeding or swelling after an injury.
It is an extremely painful condition. The pressure built up in the muscles can go beyond dangerous levels, causing a reduction in blood flow, which prevents nutrition and oxygen from reaching nerve and muscle cells.
What is compartment syndrome?
The muscles of the forearm, lower leg, and other body parts are surrounded by bands of fibrous tissue. This creates different partitions. Fibrous tissue is highly flexible and therefore does not stretch to accommodate swelling in the area (for example, due to an injury). If left untreated, the muscles and nerves here cannot function and eventually die. Sometimes compartment syndrome can become chronic due to exertion such as exercise.
Compartment syndrome can be of two types:
acute compartment syndrome: This is a medical emergency, usually caused by a serious injury. If left untreated, it can lead to permanent muscle damage.
chronic compartment syndrome: Most of the time, it is not a medical emergency. It is usually caused by athletic exertion.
What causes compartment syndrome?
In the compartment after an injury edema or blood pooling. Connective tissue is hard and cannot expand easily, resulting in increased compartment pressure. This prevents adequate blood flow to the tissues within the compartment. Such conditions can lead to severe tissue damage. The arms, abdomen, and legs are the areas most prone to developing compartment syndrome.
Acute compartment syndrome is the most common type and is usually caused by a broken leg or arm. This condition develops rapidly over hours or days. It can occur without a bone fracture and is usually caused by the following problems:
burns
crush injuries
blood clot in a blood vessel
Extremely tight bandage
Prolonged compression of a limb (especially in the period of unconsciousness)
Surgery of the blood vessels in the arm or leg
Extremely vigorous exercise
taking anabolic steroids
Chronic compartment syndrome takes days or weeks to develop. It is usually caused by regular and vigorous exercise. In this case, the thigh, hip and lower leg are usually involved.
Abdominal compartment syndrome usually occurs after a serious injury, surgery, or critical illness. Some other conditions associated with this form are as follows:
Abdominal surgery (such as liver transplant)
Trauma
Sepsis
severe abdominal bleeding
pelvic fractures
Powerful eccentric abdominal exercises
What are the symptoms of compartment syndrome?
Symptoms of acute compartment syndrome include:
A new and persistent pain in an arm or leg
Pain begins a few hours after a serious injury.
More severe pain compared to the severity of the injury
Tension, swelling, and bruising in the affected area
numbness in limb, stabbing pain
Symptoms of chronic compartment syndrome include:
Worsening cramping in the affected muscle
Symptoms that occur within half an hour of starting an exercise
Pain that seems to be relieved by rest
The symptoms of abdominal compartment syndrome are often not noticed by the patient (as the patient is often critically ill when this occurs). Doctors or family members may notice the following symptoms:
The focus of treatment is to reduce the dangerous pressure in the body compartment. Casts or splints that narrow the affected body part are removed.
People with acute compartment syndrome may need emergency surgery to reduce compartment pressure. A long incision is made through the skin and the underlying connective tissue layer to release the pressure. Other supportive treatments for this form include:
To improve blood flow to the compartment, keep the affected body part below heart level.
The patient can be given oxygen through the nose or mouth.
Fluids are given intravenously.
Pain medications may be prescribed.
Chronic compartment syndrome is treated primarily by avoiding the activity that caused it. Can follow stretching and physical therapy exercises. In the chronic form, although surgery is not urgent, it may be preferred to relieve pressure.
In the case of abdominal compartment syndrome, treatment includes vasopressors, dialysis, mechanical ventilation, etc. Includes life support measures such as In some cases, it may be necessary to open the abdomen to relieve pressure.
