An unusual double crush syndrome: femoral and sciatic neuropathy secondary to intra-abdominal firearm

Sciatic and femoral nerve neuropathies are commonly encountered causes of lower extremity dysfunctions. The sciatic nerve originates from the L4-S3 spinal nerves of the lumbosacral plexus, and the femoral nerve from the L2-L4 roots of the lumbar plexus. Traumatic, compressive, ischemic, neoplastic or idiopathic factors can lead to neuropathies of these nerves. We report a case of a 17-year-old male patient undergoing right hemicolectomy surgery following an abdominal firearm injury and with weakness around the right hip, knee and ankle in the postoperative period and paresthesia in the right knee, lateral part of the leg and dorsum of the foot

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1. Drake RL, Vogl W, Mitchell AWM; illustrations by Tibbitts RM and Richardson P; photographs by Horn A. Paul Gray’s anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. 2005.

2. Akarırmak Ü: Tuzaknöropatileri. In: Beyazova M, Gökçe-Kutsal Y, eds, Fiziksel Tıp ve Rehabilitasyon. Ankara: Güneş Kitabevi, 2000;2071-2089.

3. Akı S, Alev L, Boyacıyan A, Karan A: Siyatik sinir nöropatisine sebep olan etyolojik faktörlerin değerlendirilmesi. Türkiye Fiziksel Tıp veRehabilitasyon Dergisi. 1998;1(1):65-67.

4. Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain. 1951;74:491-516.

5. Yuen EC, So YT. Entrapment and other focal neuropathies: sciatic neuropathy. Neurol Clin. 1999;17(3):617-31.

6. Plewna C, Wallace C, Zochodne D. Traumatic sciatic neuropathy: a novel cause, local experience and review of the literature. J Trauma. 1999;47(5):986-99.

7. Kocatürk H, Yurtman V, Karaca L. Warfarin kullanımına bağlı gelişen subakut retroperitoneal kanamaya bağlı sol femoral sinir nöropatisi. Genel Tıp Derg. 2013;23(2):56-8. 11

8. Zago G, Appel-da-Silva MC, Danzmann LC. Iliopsoas muscle hematoma during treatment with warfarin. Arq Bras Cardiol. 2010;94(1):1-3.

9. Krause ML, Post JA. 73-year-old woman with anterior thigh pain. Mayo Clin Proc. 2011;86(4):21-4.

10. Murray IR, Perks FJ, Beggs I, Moran M. Femoral nerve palsy secondary to traumatic iliacus haematoma- a young athlete’s injury. BMJ Case Rep. 2010;2010.

11. Van Langenhove M, Pollefliet A. Vanderstraeten G. A retrospective electrodiagnostic evaluation of footdrop in 303 patients. Electromyogr Clin Neurophysiol. 1989;29(3):145-52. 20.

12. Kim DH, Murovic JA, Tiel R, Kline DG. Management and outcomes in 353 surgically treated sciatic nerve lesions. J Neurosurg. 2004;101:8-17.

13. Huang Y, Yan Q, Lei W. Gluteal sciatic nerve injury and its treatment. ZhongguoXiu Fu Chong Jian Wai Ke Za Zhi. 2000;14(2):83‐6.

14. Yuen EC, Onley RK, So YT. Sciatic neuropathy: clinical and prognostic features in 73 patients. Neurology. 1994;44(9):1669-74.

15. Wang JQ, Yi MJ, Zhu Y, Wang MY, Zhang BS, Liu DQ, Wei J. Surgical treatment of shotgun injuries of the sciatic nerve. Zhonghua Wai Ke Za Zhi. 2004;42(2):81-3.

16. Kong WK, Cho KT, Lee HJ, Choi JS. Femoral neuropathy due to iliacus muscle hematoma in a patient on warfarin therapy. J Korean Neurosurg Soc. 2012;51(1):51-3.

17. Çeliker R, Alt Ekstremitelerde Tuzak Nöropatiler, Türk Fiz Tıp Rehab Derg. 2009;55(1):30- 15.