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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
BENEVIDES, Márcio Luiz and NOCHI JUNIOR, Rubens Jardin. Rhabdomyolysis secondary to gluteal compartment syndrome after bariatric surgery: case report. Rev. Bras. Anestesiol. [online]. 2006, vol.56, n.4, pp.408-412. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942006000400009.
BACKGROUND AND OBJECTIVES: Bariatric surgery has become a common procedure and several complications have been reported. The objective of this report is to present a case of gluteal compartment syndrome that evolved to acute renal failure after bariatric surgery and to discuss the diagnosis, and the prophylactic and therapeutic measures. CASE REPORT: A 42 years old male patient, white, with a body mass index (BMI) of 43, physical status ASA II, who underwent bariatric surgery of the duodenal switch type, under general anesthesia associated with epidural anesthesia. There were no complications during the procedure. The anesthetic-surgical procedure lasted 3 hours and 30 minutes. On postoperative day one the patient developed lumbosacral and gluteal pain, besides paresthesia in the lower limbs in the distribution of the sciatic nerve. On physical exam, the buttocks were slightly pale, tight, swollen, and painful to palpation and to movement. A diagnosis of gluteal compartment syndrome was made; it evolved to rhabdomyolysis and acute renal failure. The renal function improved and the patient did not present any motor or sensitive deficits. CONCLUSIONS: Patients with morbid obesity undergoing bariatric surgery may present gluteal compartment syndrome as a complication. When it is not diagnosed and treated promptly, it may evolve to rhabdomyolysis and acute renal failure, which represents a serious life-threatening situation.
Keywords : COMPLICATIONS [gluteal compartimental syndrome, rabdomiolisis, renal insufficiency]; DISEASES, Morbidity obesity; SURGERY, Bariatric.