Symptomatic extravasation of irrigation fluid is a rare complication of hip arthroscopy. However, depending on the amount of fluid, intra-abdominal hypertension (IAH) may occur and even develop into abdominal compartment syndrome, which can seriously alter hemodynamic circulation. Therefore, it is important for anesthesiologists to promptly recognize the abnormal signs of IAH for early diagnosis and better clinical outcomes. Nevertheless, these signs are difficult to detect because they are usually obscured when the patient is under anesthesia and masked by surgical drapes. We report a case of IAH under general anesthesia during hip arthroscopy to highlight possible symptoms and signs.
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Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder of uncertain etiology that affect synovial lined joints. This disesse is an uncommon that usually afflicts the knee joint. Two types of villi are present in this disease, localized form is called ‘nodular PVNS’ and non localized form is ‘diffuse PVNS’. On microscopy, PVNS is characterized by the presence of hemosiderin-laden, multinucleated, giant cells. But plain radiograph in PVNS shows normal finding exclude effusion, so cannot help diagnosis of PVNS. We experienced a case of a 59-years-old male patient who complained multiple arthralgia, swelling, limit of motion of Lt knee. We gave diagonsis of gout with PVNS by MRI and arthroscopic procedure. So we report this case with review of literature.
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