Atypical Acute Compartment Syndrome

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Acute compartment syndrome involving an extremity is a surgical emergency that typically occurs following traumatic injuries (e.g., fracture, crush injury, prolonged compression) or excessive exercise, in which elevated pressure within a fascial compartment disrupts the blood flow to and from the enclosed tissues and results in loss of function, severe tissue damage, myonecrosis, and even death. This month’s “Case Connections” highlights the cases of 4 patients in whom acute compartment syndrome developed following nontraumatic and nonexertional causes, including muscle ischemia secondary to McArdle disease, spontaneous bleeding due to an acquired factor VIII inhibitor, toxic shock and infectious pyomyositis, and prolonged exposure to subatmospheric pressure.
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