J.Jpn. Surg. Soc.. 82(9): 1028-1032, 1981
Report on the annual meeting
MUSCULAR, RENAL AND METABOLIC COMPLICATIONS OF ACUTE ARTERIAL OCCLUSIONS: ANALYSIS OF EIGHT CASES
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*) First Department of Surgery, Nagasaki University School of Medicine Toshiyasu Kugimiya*), Kenichi Fukushima*), Eisuke Kusaba*), Masayuki Kuroiwa*), Masatake Takagi*), Hisataka miyagawa*), Yuji Takagi*), Joji Shirabe**), Tetsuo Hadama**), Kiyohiko Kaku**) |
Reconstructive surgeries delayed in the majority of cases for more than 12 hours after the onsets. The pedal pulses became palpable in all operated cases during the early postoperative periods, but soon followed by painful swelling and rigidity of the limbs with myoglobinuria. Preoperative detection of the urinary myoglobin is of diagnostic importapce for MNMS. Myoglobinuria is strongly suspected when the urinary occlut blood is positive and naked-eye look at the serum is clear, because unlike the hemoglobin, the myoglobin is easily excreted in the urine and the serum myoglobin concentration rarely exceeds visible levels of 50 mg%. Elevation of some serum enzymes (CPK, LDH, GOT ets.) were also helpful for diagnosis of MNMS.
Concurrent extensive faciotomies, correction of the body fluid, electrolites and acid-base balance, and positive measures for maintaining the urinary output were effective in the prevention and treatment of MNMS.
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