Atraumatic acute compartment syndrome in anticoagulated patient: A case report

Compartment syndrome is a well-known surgical emergency caused by increasing pressure inside the fascial or osteo-fascial compartment, resulting in vascular compromise, ischemia, and necrosis. This condition usually occurs following a traumatic incident. Here we present a report of nontraumatic acute compartment syndrome caused by systemic anticoagulation in patients presenting with the acute coronary syndrome. We report a case of a 51-year-old male with acute coronary syndrome receiving systemic anticoagulation, which later developed significant swelling and tensing on his right arm. He also complained of pallor and paresthesia with decreased peripheral oxygen saturation on his right arm. The patient was diagnosed with atraumatic acute compartment syndrome and underwent fasciotomy promptly. His symptoms improved after undergoing fasciotomy. Atraumatic acute compartment syndrome is a rare case. Identifying this condition without a typical history of underlying predisposition is important to avoid delaying emergent surgery as the key therapy. •There are limited reports on the compartment syndrome of atraumatic origin.•Anticoagulation and conditions that impairs coagulation may increase the risk of these hypothetical patophysiology•Atraumatic acute compartment syndrome is a challenging diagnosis as the precipitating elements are not widely known.•These cases can very easily be neglected and prompt treatment could be delayed.