Choi JH, Oh HM, Hwang JH, Kim KS, Lee SY. Rare case of compartment syndrome provoked by inhalation of polyurethane agent: A case report. World J Clin Cases 2022; 10(22): 8003-8008 [PMID: 36158470 DOI: 10.12998/wjcc.v10.i22.8003]
Corresponding Author of This Article
Jae Ha Hwang, MD, PhD, Professor, Surgeon, Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, South Korea. psjhhwang@daum.net
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2022; 10(22): 8003-8008 Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.8003
Rare case of compartment syndrome provoked by inhalation of polyurethane agent: A case report
Jun Ho Choi, Hyun Myung Oh, Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee
Jun Ho Choi, Hyun Myung Oh, Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Gwangju 61469, South Korea
Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee, Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju 61469, South Korea
Author contributions: Choi JH and Oh HM contributed to manuscript writing and data collection; Hwang JH and Kim KS contributed to editing and conceptualization; Lee SY contributed to supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jae Ha Hwang, MD, PhD, Professor, Surgeon, Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, South Korea. psjhhwang@daum.net
Received: February 10, 2022 Peer-review started: February 10, 2022 First decision: June 15, 2022 Revised: June 18, 2022 Accepted: July 6, 2022 Article in press: July 6, 2022 Published online: August 6, 2022
Abstract
BACKGROUND
The most common causes of compartment syndrome in the lower extremities include lower limb fractures, trauma-induced crushing injuries, severe burns, and non-traumatic factors. However, there have been no reports of compartment syndrome secondary to toxic inhalation.
CASE SUMMARY
A 59-year-old man, who lost consciousness after applying polyurethane-based paint on a water tank, was brought to the emergency room. The initial blood test showed apparent rhabdomyolysis. One day later, pain and swelling in both legs were observed, and the physical examination confirmed the presence of compartment syndrome. Double-incision fasciotomy was performed on both legs. Frequent dressings and negative pressure wound treatment were done on both legs, and skin grafting was performed after healthy granulation tissue had been identified. No other complications were observed after treatment. However, symptoms of peroneal neuropathy, particularly limited ankle dorsiflexion and reduced sensation on the lower extremities, were observed.
CONCLUSION
Workers using polyurethane agents should wear gas masks and be evaluated for compartment syndrome and rhabdomyolysis secondary to toxic inhalation.
Core Tip: Compartment syndrome secondary to non-traumatic etiology is often diagnostically challenging based solely on history taking and may be misdiagnosed in the absence of comprehensive physical evaluation. Moreover, to date, no study has reported compartment syndrome caused by inhalation toxicity. We report a rare case of compartment syndrome secondary to polyurethane inhalation.
