Coma blister in nontraumatic rhabdomyolysis
| Autor: | Yu-Jang Su, Kuo-Song Chang |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Compartment Syndromes Rhabdomyolysis Fasciotomy 030207 dermatology & venereal diseases 03 medical and health sciences Blister 0302 clinical medicine medicine Humans 030212 general & internal medicine Coma integumentary system business.industry Blisters General Medicine medicine.disease Surgery Plastic surgery Blood pressure Coma blister Anesthesia Emergency Medicine medicine.symptom business |
| Zdroj: | The American Journal of Emergency Medicine. 34:1324.e1-1324.e2 |
| ISSN: | 0735-6757 |
| Popis: | A40-year-oldmanpresentedatouremergency departmentwithhis left forearm swollen with palmar blisters. He did not remember what had happened to him, and he was unconscious for 1 day before arrival at the hospital. He was afebrile (37°C), with a heart rate of 92 beats per minute, and blood pressure at 136/94 mm Hg. Laboratory tests showed high creatine phosphokinase: 38655 IU/L; creatinine of 2.7 mg/dL; glutamic oxaloacetic transminase of 533 IU/L, and an elevated white blood cell count of 20300/mL. Palmar blisters and cyanotic change of the distal digit of a small finger were found. After emergent consultation with a plastic surgeon, left forearm compartment syndrome with coma blisters concomitant with rhabdomyolysis was diagnosed. Emergent fasciotomy after debridement was performed immediately. A split thickness skin graft for the skin defect was performed. After an 11-day hospitalization, the patient was advised against discharge due to personal factors. Coma blisters are commonly seen in patients who present with local pressure-related tissue hypoxia. Degenerated epidermis and sweat gland degeneration result in tense bullae formation. Emergent fasciotomy is mandatory when compartment syndrome is observed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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