Ishibashi et al described the gluteal compartment syndrome after abdominal aortic aneurysm repair. The authors are from Aichi Medical University in Japan.
Compartments in the gluteal region:
(1) gluteus maximus
(2) gluteus medius
(3) gluteus minimus
Causes for the compartment syndrome:
(1) aneurysm or rupture of the abdominal aorta or superior gluteal artery
(2) trauma
(3) crush syndrome in an unconscious patient recumbant for prolonged period, including surgical positioning
(4) ischemic-reperfusion injury
(5) bone marrow biopsy from the iliac crest
(6) sickle cell disease
(7) thromboembolism
Clinical features:
(1) swelling, pain and tenderness
(2) rhabdomyolysis with increased serum CK and risk for acute renal failure
(3) swelling of muscle in the compartment on CT scan with decreased density
(4) increased pressure within the compartment
M. gluteus maximus
Pressure
normal compartment pressure
0 - 13 mm Hg
indication for fasciotomy
30 - 45 mm Hg
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