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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2013  |  Volume : 24  |  Issue : 2  |  Page : 326-329
Delayed compartment syndrome following brachiocephalic arteriovenous fistula formation in a hemodialysis patient

1 Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, North Rhine-Westphalia, Germany
2 Sheffield Kidney Institute, Sheffield Teaching Hospitals, Sheffield, United Kingdom

Correspondence Address:
Sammy Al-Benna
Department of Plastic and Reconstructive Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, North Rhine-Westphalia
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DOI: 10.4103/1319-2442.109595

PMID: 23538359

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Delayed compartment syndrome following the surgical creation of an arteriovenous fistula (AVF) for vascular access is rare. A 71-year-old male patient experienced left anterior forearm compartment syndrome caused by a brachiocephalic AVF. The fistula failed after five days. Immediate radiological de-clotting failed and the thrombosed fistula was de-clotted with the help of a Fogarty balloon. On Day 11, the patient developed symptoms and signs of acute anterior forearm compartment syndrome and underwent immediate surgical decompression of the superficial and deep flexor compartments, which resulted in an excellent outcome. Iatrogenic forearm compartment syndrome is a rare but potential complication after creation of AVF. The critical errors regarding compartment syndrome are failure to recognize or failure to act. This case report illustrates that swift diagnosis and immediate surgical intervention results in an excellent outcome and avoids the morbidity associated with this potentially devastating and debilitating process.

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