Acute Hand Compartment Syndrome Following Contrast Media Extravasation: A Case Report

Introduction:Contrast media extravasation is a well-recognized complication in emergency imaging, yet progression to acute compartment syndrome remains exceedingly rare. Early identification and rapid intervention are essential to prevent irreversible neurovascular damage.Case Report:A 64-year-old female undergoing contrast-enhanced brain CT for recurrent syncope received 100 mL of iopromide via a peripheral catheter placed on the dorsum of the right hand. She developed immediate pain followed within 30 minutes by rapidly progressive swelling, tense compartments, and dorsal bullae. Radiographs confirmed extensive contrast extravasation. Clinical assessment revealed pain disproportionate to injury, firm compartments on palpation, and multiple bullae—findings consistent with acute compartment syndrome. Emergent decompressive fasciotomy was performed within one hour, leading to rapid postoperative improvement and complete functional recovery by the three-month follow-up.Conclusion:Although typically benign, contrast media extravasation can occasionally lead to acute compartment syndrome. Clinical vigilance, early suspicion, prompt diagnosis, and timely fasciotomy within the critical therapeutic window are key to preventing permanent functional impairment.