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Extravasation of radiographic contrast material and compartment syndrome in the hand: a case report.

Belzunegui T, Louis CJ, Torrededia L, Oteiza J - Scand J Trauma Resusc Emerg Med (2011)

Bottom Line: The patient developed a compartment syndrome and a fasciotomy was required.Treatment options are outlined and emphasis is made on prevention of this iatrogenic complication.Some of the preventive measures to avoid these complications include use of non-ionic contrast (low osmolarity), careful choice of the site of intravenous administration, and close monitoring of the patient during injection of contrast to minimize or prevent extravasation injuries.Clear information to patients and prompt recognition of the complication can allow for other non-surgical treatment options than the one required in this case.

View Article: PubMed Central - HTML - PubMed

Affiliation: Emergency Department, Hospital de Navarra, Navarra, Pamplona, Navarra, Spain. tomas.belzunegui@unavarra.es

ABSTRACT
Radiocontrast agents are a type of medical contrast material used to improve the visibility of internal bodily structures in X-ray based imaging techniques such as computed tomography (CT) or radiography. Radiocontrast agents are typically iodine or barium compounds.Extravasation of contrast is a possible complication of imaging studies performed with contrasts. Most extravasations cause minimal swelling or erythema, however, skin necrosis, ulceration and compartment syndrome may occur with extravasation of large volumes of contrast. A case report is presented in which significant extravasation of contrast was caused while injecting the contrast intravenously into the back of the hand of a 50 year old patient during computed tomography. The patient was undergoing chemotherapy. The patient developed a compartment syndrome and a fasciotomy was required. Treatment options are outlined and emphasis is made on prevention of this iatrogenic complication.Some of the preventive measures to avoid these complications include use of non-ionic contrast (low osmolarity), careful choice of the site of intravenous administration, and close monitoring of the patient during injection of contrast to minimize or prevent extravasation injuries. Clear information to patients and prompt recognition of the complication can allow for other non-surgical treatment options than the one required in this case.

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Related in: MedlinePlus

Image showing the right hand of the patient; tissue tension, global swelling, paleness, and blisters in the dorsal region can be observed.
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Figure 1: Image showing the right hand of the patient; tissue tension, global swelling, paleness, and blisters in the dorsal region can be observed.

Mentions: Physical examination showed a pale, tense and swollen hand, with blisters on the back and loss of sensation. Capillary refill was increased and the patient was unable to move her right fingers, and any attempt to do so was extremely painful (Figure 1).


Extravasation of radiographic contrast material and compartment syndrome in the hand: a case report.

Belzunegui T, Louis CJ, Torrededia L, Oteiza J - Scand J Trauma Resusc Emerg Med (2011)

Image showing the right hand of the patient; tissue tension, global swelling, paleness, and blisters in the dorsal region can be observed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3044092&req=5

Figure 1: Image showing the right hand of the patient; tissue tension, global swelling, paleness, and blisters in the dorsal region can be observed.
Mentions: Physical examination showed a pale, tense and swollen hand, with blisters on the back and loss of sensation. Capillary refill was increased and the patient was unable to move her right fingers, and any attempt to do so was extremely painful (Figure 1).

Bottom Line: The patient developed a compartment syndrome and a fasciotomy was required.Treatment options are outlined and emphasis is made on prevention of this iatrogenic complication.Some of the preventive measures to avoid these complications include use of non-ionic contrast (low osmolarity), careful choice of the site of intravenous administration, and close monitoring of the patient during injection of contrast to minimize or prevent extravasation injuries.Clear information to patients and prompt recognition of the complication can allow for other non-surgical treatment options than the one required in this case.

View Article: PubMed Central - HTML - PubMed

Affiliation: Emergency Department, Hospital de Navarra, Navarra, Pamplona, Navarra, Spain. tomas.belzunegui@unavarra.es

ABSTRACT
Radiocontrast agents are a type of medical contrast material used to improve the visibility of internal bodily structures in X-ray based imaging techniques such as computed tomography (CT) or radiography. Radiocontrast agents are typically iodine or barium compounds.Extravasation of contrast is a possible complication of imaging studies performed with contrasts. Most extravasations cause minimal swelling or erythema, however, skin necrosis, ulceration and compartment syndrome may occur with extravasation of large volumes of contrast. A case report is presented in which significant extravasation of contrast was caused while injecting the contrast intravenously into the back of the hand of a 50 year old patient during computed tomography. The patient was undergoing chemotherapy. The patient developed a compartment syndrome and a fasciotomy was required. Treatment options are outlined and emphasis is made on prevention of this iatrogenic complication.Some of the preventive measures to avoid these complications include use of non-ionic contrast (low osmolarity), careful choice of the site of intravenous administration, and close monitoring of the patient during injection of contrast to minimize or prevent extravasation injuries. Clear information to patients and prompt recognition of the complication can allow for other non-surgical treatment options than the one required in this case.

Show MeSH
Related in: MedlinePlus