We report a case of 50-year-old man who presented with acute compartment syndrome of the left lower limb after abdominal aortic aneurysm repair. He had past history of vasospastic angina which was diagnosed by acetylcholine provocation test 7 years before the operation. He had several episodes of lower leg pain, which sustained around 15-30 minutes during rest. Scheduled Y graft replacement was performed with total operative time of 245 minutes and total ischemic time of 111 minutes. He

more »

... ed of severe pain of his left lower limb just after the operation. Laboratory data showed increased transaminase (aspartate transaminase 363mg/dl, alanine transaminase 99mg/dl) and creatine kinase (36273mg/dl). Contrast computed tomography (CT) demonstrated normal vasculature of the anterior tibial, posterior tibial and peronial arteries, however, significant swelling of the soleus muscle was found (Figure 1 ). Although infusion of heparin and prostaglandin E1 were started, compartment syndrome had developed and fasciotomy was performed. Discoloration of the toes of the left foot started one week after the operation and deteriorated (Figure 2) . Amputation of the second, third and fourth toes was performed 4 months after the operation.