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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Morhij, Rossel Tucker, Sarah Dunphy, Louise |
| Description | Author Affiliation: Dunphy L ( Department of Plastic Surgery, John Radcliffe Hospital, Oxford, UK.); Morhij R ( Department of Plastic Surgery, John Radcliffe Hospital, Oxford, UK.); Tucker S ( Department of Plastic Surgery, John Radcliffe Hospital, Oxford, UK.) |
| Abstract | A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3â days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5â mg once daily and atorvastatin 20â mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome. His creatine kinase was >50â 000â IU with normal renal and liver function tests. Further investigation with MRI-identified prominent swelling of the vastus intermedius and medialis muscles, more marked on the left, with extensive diffuse short tau inversion recovery (STIR) signal hyperintensity and isointensity on T1 sequences, suggestive of rhabdomyolysis. He underwent bilateral fasciotomies of his thighs and aggressive intravenous fluid resuscitation with close monitoring of his electrolytes. Intraoperatively his muscle was healthy, with no evidence of haematoma or necrosis. His medication atorvastatin was stopped due to his rhabdomyolysis. 48â hours later, he returned to theatre and review of his fasciotomy wounds was unremarkable. 4â days later, he was discharged uneventfully. His postoperative recovery was complicated by a serous discharge from his left medial thigh wound. Further investigation with an ultrasound confirmed a 4×1×1cm multiloculated collection within the superficial tissue directly underlying the wound. An aspirate was performed and cultures revealed no growth. He remains under review in the department of plastic surgery. This case report discusses the aetiological spectrum, clinical presentation, pathophysiology, differential diagnosis, investigations, management and complications of rhabdomyolysis. |
| Journal | BMJ Case Reports |
| Volume Number | 2017 |
| e-ISSN | 1757790X |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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