Zusammenfassung
Die Inzidenz von Kontrastmittelparavasaten wird in der Literatur mit 0,2–0,9 % angegeben. Eine seltene Folge kann ein Kompartmentsyndrom der betroffenen Extremität sein, welches sofortiger Behandlung bedarf.
Wir berichten über einen Patienten, dem im Rahmen eines Polytrauma-CT-Scans Kontrastmittel radiovolar i. v. appliziert wurde. Im Verlauf kam es durch Paravasation von Kontrastmittel zu einem Kompartmentsyndrom. Sowohl das klinische Beschwerdebild mit deutlicher Schmerzsymptomatik, als auch der Verlust von motorischen und sensiblen Funktionen, wie auch die Kompartmentdruckmessung und die radiologische Bildgebung sicherten die Diagnose. Durch die notallmäßig durchgeführte Dermatofasziotomie erhielt der Patient eine völlige Wiederherstellung der zuvor verlorengegangenen motorischen und sensiblen Funktion.
Abstract
The incidence of extravasation of contrast medium is reported in the literature to be between 0.2 % and 0.9 %. A rare consequence of this could be compartment syndrome of the affected limb which requires immediate treatment.
We report the case of a patient who developed acute compartment syndrome of the forearm after intravenous injection of radiographic contrast medium in a radiovolar vein during a computed tomography (CT) scan for multiple trauma. The clinical symptoms with pain, loss of range of motion and sensitivity functions, measurement of compartment pressure and radiological images confirmed the diagnosis. After emergency dermatofasciotomy of the forearm the full range of motion and sensitivity functions could be restored.
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Hawi, N., Citak, M., Liodakis, E. et al. Kompartmentsyndrom nach paravasaler Applikation von Röntgenkontrastmittel. Unfallchirurg 117, 374–379 (2014). https://doi.org/10.1007/s00113-013-2393-2
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DOI: https://doi.org/10.1007/s00113-013-2393-2