Abstract
Intravenous administration of iodinated contrast agents is widely used in radiologic imaging. The vast majority of extravasation cases are mild and recover with conservative methods. However, in cases of large-volume extravasation, serious complications such as acute compartment syndrome (ACS) and widespread soft tissue necrosis may develop. In this study, a case of ACS due to contrast agent extravasation in an 83-year-old female patient with a history of dementia and hypertension is presented. This case demonstrates that even small volumes of contrast agents with low osmolality and non-ionic properties can cause serious tissue damage after extravasation. Advanced age, cognitive impairment, and injections into peripheral vascular regions such as the dorsum of the hand increase risk factors. Early recognition of extravasation and timely plastic surgery consultation are critical in reducing morbidity. It is recommended to prefer thicker-lumen cannulas for injection, use proximal veins, and avoid high-risk anatomical regions.
References
- Bicer A, Ercin BS, Gürler T, Yiğittürk G, Uyanikgil Y, Cetin EO. Possibility of Taking an Offensive Stance in Extravasation Injury: Effects of Fat Injection in Vesicant (Doxorubicin) Induced Skin Necrosis Model in Rats. Journal of InvestIgatIve surgery. 2022;35(4):801-8.
- Al-Benna S, O’boyle C, Holley J. Extravasation injuries in adults. International Scholarly Research Notices. 2013;2013(1):856541.
- Vinod KV, Shravan R, Shrivarthan R, Radhakrishna P, Dutta TK. Acute compartment syndrome of hand resulting from radiographic contrast iohexol extravasation. Journal of Pharmacology and Pharmacotherapeutics. 2016;7(1):44-7.
- Pasternak JJ, Williamson EE, editors. Clinical pharmacology, uses, and adverse reactions of iodinated contrast agents: a primer for the non-radiologist. Mayo Clinic Proceedings; 2012: Elsevier.
- Lake C, Beecroft CL. Extravasation injuries and accidental intra-arterial injection. Continuing Education in Anaesthesia, Critical Care & Pain. 2010;10(4):109-13.
- Wang CL, Cohan RH, Ellis JH, Adusumilli S, Dunnick NR. Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69 657 intravenous injections. Radiology. 2007;243(1):80-7.
- Kokaçya Ö, Tabakan İ, Servet E. Radyografik kontrast maddenin damar dışına kaçmasına bağlı üst ekstremitede kompartman sendromu ve el dorsalinde doku defekti. Cukurova Medical Journal. 2018;43(1):207-10.
- Belzunegui T, Louis CJ, Torrededia L, Oteiza J. Extravasation of radiographic contrast material and compartment syndrome in the hand: a case report. Scandinavian journal of trauma, resuscitation and emergency medicine. 2011;19:1-4.
- Wienbeck S, Fischbach R, Kloska SP, Seidensticker P, Osada N, Heindel W, et al. Prospective study of access site complications of automated contrast injection with peripheral venous access in MDCT. American Journal of Roentgenology. 2010;195(4):825-9.
- Smith R. Prevention and treatment of extravasation. British Journal of Parenteral Therapy. 1985;6(5):114-8.
Abstract
İyotlu kontrast maddelerin intravenöz yoldan uygulanması radyolojik görüntülemede yaygın olarak kullanılmaktadır. Ekstravazasyon vakalarının büyük çoğunluğu hafif seyretmekte ve konservatif yöntemlerle iyileşmektedir. Ancak büyük hacimli ekstravazasyon durumlarında, akut kompartman sendromu (AKS) ve yaygın yumuşak doku nekrozu gibi ciddi komplikasyonlar gelişebilmektedir. Bu çalışmada, demans ve hipertansiyon öyküsü bulunan 83 yaşındaki kadın hastada kontrast madde ekstravazasyonuna bağlı gelişen AKS olgusu sunulmaktadır. Bu olgu, düşük osmolaliteye ve non-iyonik özelliklere sahip kontrast maddelerin dahi küçük hacimlerde ekstravazasyonu sonrası ciddi doku hasarına yol açabileceğini göstermektedir. İleri yaş, bilişsel bozukluk ve el sırtı gibi periferik damar bölgelerine yapılan enjeksiyonlar risk faktörlerini artırmaktadır. Ekstravazasyonun erken fark edilmesi ve zamanında plastik cerrahi konsültasyonu, morbiditenin azaltılmasında kritik öneme sahiptir. Enjeksiyon için daha kalın lümenli kanüllerin tercih edilmesi, proksimal venlerin kullanılması ve yüksek riskli anatomik bölgelerden kaçınılması önerilmektedir.
Keywords
Ethical Statement
Yazarlar arasında çıkar çatışması bulunmamaktadır. Yazarlar çalışmaya eşit katkı sunmuştur. Hastadan tanı, tedavi ve akademik nedenler ile her aşamada sözel ve yazılı onam alınmıştır. Çalışma için ekonomik destek alınmamıştır.
Supporting Institution
yok
Thanks
teşekkürler
References
- Bicer A, Ercin BS, Gürler T, Yiğittürk G, Uyanikgil Y, Cetin EO. Possibility of Taking an Offensive Stance in Extravasation Injury: Effects of Fat Injection in Vesicant (Doxorubicin) Induced Skin Necrosis Model in Rats. Journal of InvestIgatIve surgery. 2022;35(4):801-8.
- Al-Benna S, O’boyle C, Holley J. Extravasation injuries in adults. International Scholarly Research Notices. 2013;2013(1):856541.
- Vinod KV, Shravan R, Shrivarthan R, Radhakrishna P, Dutta TK. Acute compartment syndrome of hand resulting from radiographic contrast iohexol extravasation. Journal of Pharmacology and Pharmacotherapeutics. 2016;7(1):44-7.
- Pasternak JJ, Williamson EE, editors. Clinical pharmacology, uses, and adverse reactions of iodinated contrast agents: a primer for the non-radiologist. Mayo Clinic Proceedings; 2012: Elsevier.
- Lake C, Beecroft CL. Extravasation injuries and accidental intra-arterial injection. Continuing Education in Anaesthesia, Critical Care & Pain. 2010;10(4):109-13.
- Wang CL, Cohan RH, Ellis JH, Adusumilli S, Dunnick NR. Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69 657 intravenous injections. Radiology. 2007;243(1):80-7.
- Kokaçya Ö, Tabakan İ, Servet E. Radyografik kontrast maddenin damar dışına kaçmasına bağlı üst ekstremitede kompartman sendromu ve el dorsalinde doku defekti. Cukurova Medical Journal. 2018;43(1):207-10.
- Belzunegui T, Louis CJ, Torrededia L, Oteiza J. Extravasation of radiographic contrast material and compartment syndrome in the hand: a case report. Scandinavian journal of trauma, resuscitation and emergency medicine. 2011;19:1-4.
- Wienbeck S, Fischbach R, Kloska SP, Seidensticker P, Osada N, Heindel W, et al. Prospective study of access site complications of automated contrast injection with peripheral venous access in MDCT. American Journal of Roentgenology. 2010;195(4):825-9.
- Smith R. Prevention and treatment of extravasation. British Journal of Parenteral Therapy. 1985;6(5):114-8.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Plastic Reconstructive and Aesthetic Surgery |
| Journal Section | Case Report |
| Authors | |
| Publication Date | December 8, 2025 |
| Submission Date | May 10, 2025 |
| Acceptance Date | July 4, 2025 |
| Published in Issue | Year 2025 Volume: 64 Issue: 4 |
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