A child taken for CECT chest was injected a contrast. Immediately after the injection she developed a swelling at the site of injection which gradually increased. She also complained of numbness and pain on passive extension of fingers. On examination radial pulse is feeble. What should be done next?
The child has most likely developed compament syndrome secondary to aerial puncture and hematoma formation. Immediate fasciotomy should be done in this case , any delay in treatment by 6-8 hours can lead to irreversible nerve and muscle damage. Compament syndrome: is a limb threatening and life threatening condition, defined as the compression of nerves, blood vessels, and muscle inside a closed space (compament) within the body. It is characterised by pain out of propoion to what is expected, paresthesia, pallor, paralysis and pulselessness.
High dose prednisolone + antihistamines
Angiography
Immediate fasciotomy
Surgical exploration