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Compartment Syndrome

(continued)

Compartment Syndrome Symptoms continued...

 

Symptoms of chronic compartment syndrome (exertional compartment syndrome) include aching or cramping in the affected muscle (buttock, thigh, or lower leg) within a half-hour of starting exercise. Symptoms usually go away with rest, and muscle function remains normal. Exertional compartment syndrome can feel like shin splints and be confused with that condition. 

Abdominal compartment syndrome usually develops in people who are hospitalized and critically ill on life support. They usually cannot describe their symptoms. Doctors or family may notice the abdominal compartment syndrome symptoms and signs: 

  • A tense, distended abdomen
  • Wincing when the abdomen is pressed
  • Urine output that slows down or stops
  • Low blood pressure

 

Compartment Syndrome Diagnosis

A doctor may suspect compartment syndrome based on the type of injury, a person's description of symptoms, and a physical exam. Sometimes, the diagnosis of compartment syndrome is clear from these findings. 

In many cases, a definite diagnosis of compartment syndrome requires direct measurement of pressures inside the body compartment. To do this, a doctor can insert a needle into the area of suspected compartment syndrome while an attached pressure monitor records the pressure. A plastic catheter can also be inserted to monitor the compartment pressure continuously. 

In suspected abdominal compartment syndrome, a pressure monitor can be inserted into the bladder through a urinary catheter. High pressures in the bladder, when there are signs of abdominal compartment syndrome, strongly suggest the diagnosis. 

Laboratory and imaging tests can support the diagnosis of compartment syndrome. But no single test other than a direct pressure measurement can make the abdominal compartment syndrome diagnosis.

 

Compartment Syndrome Treatments

Treatments for compartment syndrome focus on reducing the dangerous pressure in the body compartment. Dressings, casts, or splints that are constricting the affected body part must be removed. 

Most people with acute compartment syndrome require surgery to reduce the compartment pressure. A surgeon makes long incisions through the skin and the fascia layer underneath (fasciotomy), releasing excessive pressure. 

Other supportive treatments include:

  • Keeping the body part below the level of the heart (to improve blood flow into the compartment)
  • Giving oxygen through the nose or mouth
  • Giving fluids intravenously
  • Taking pain medications 

Chronic compartment syndrome can first be treated by avoiding the activity that caused it and with stretching and physical therapy exercises. Surgery is not as urgent in chronic or exertional compartment syndrome, but it may be required to relieve pressure.

Abdominal compartment syndrome treatments include life support measures like mechanical ventilation, medicines to support blood pressure (vasopressors), and kidney replacement therapies (such as dialysis). Surgery to reduce the compartment syndrome pressures may be necessary. The best time to perform surgery in people with abdominal compartment syndrome is often not clear. Surgery for abdominal compartment syndrome may be lifesaving, but can also cause complications.

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WebMD Medical Reference

Reviewed by Kimball Johnson, MD on October 17, 2012
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