Lower Limb Compartment Syndrome Following Laparoscopic-Assisted Myomectomy

Lower limb compartment syndrome is caused by abnormal increases in intracompartmental pressures in a non-expansile fascial space. It results not only in muscle necrosis, pararesthesia, and renal failure, but may also necessitate amputation of the lower limb or cause the patient's death. It is believed to be a rare complication following gynecologic surgery; however, gynecologists should be aware of the risk factors for this life-threatening disease. We report a case of a 38-year-old obese woman (body mass index = 27) presenting with lower limb compartment syndrome after laparoscopic-assisted myomectomy performed in a lithotomy position. Postoperatively, she complained of pain in her left lower extremity and paresthesia after 1 day; drop foot appeared after 2 days. Five days postoperatively, she underwent fasciotomy to reduce the pain. Her drop foot recovered after 9 weeks, and she fortunately became able to walk almost normally. This case highlights the importance of assessment for risk factors for lower limb compartment syndrome, which can be a life-threatening complication.