[Compartmental syndrome in a traumatized patient under VKA a case report]

ABSTRACT

Oral anticoagurlation inducing bleeding is a worrying problem because of its frequency and potential gravity. The major determinants of haemorrhage are drug interactions and patient characteristics such as heredity, kind of food and age. Authors report the case of a 76 years old diabetic man with a history of atrial fibrillation treated by vitamin K antagonists [VKA] for more than two years. He presented with a compartmental syndrome of the upper right limb consecutive to a trauma that had been treated by nonsteroidal anti-inflammatory [NSAI] drugs. So he was admitted in an intensive care unit, the NSAI drugs were interrupted and the VKA substituted by low-molecular-weight heparin, while the affected limb was elevated and the patient prepared for operation. But a prolonged prothrombin time [Fr], along with the patient's delayed presentation, were reasons to delay surgery. Course was unusually favourable, nerve suffering signs disappeared and resorption of haematoma was noted. Authors remind in this paper the high risks of drug interactions VKA-NSAI, which can lead to a compartmental syndrome. They also remind the indications of surgical decompression depending on the time of presentation