Delayed Presentation of Foot Compartment Syndrome

A 30-year-old male after consuming alcohol and drugs lost consciousness and passed out in his bathroom. After 10 hours, he was found immobilized stuporous on his bathroom floor and brought by emergency service to the emergency room. He was found to have compartment syndrome of the right lower limb and underwent emergency fasciotomy of three compartments of the thigh and four compartments of the leg. The postoperative course was complicated by acute kidney injury necessitating hemodialysis. On postoperative day three from the index fasciotomy patient was found to develop foot compartment syndrome despite not having foot compartment involved in the initial presentation. In opioid abuse, patients' additional compartments can get involved during the disease process, and it is essential to identify them with regular physical examination and use of biomarkers.