Case Report: Suspected Lower Limb Congestive Injury Associated with Decreased Compliance of the External Iliac Vein After Laparoscopic Myomectomy

@article{chen2026case,
  title = {{Case Report: Suspected Lower Limb Congestive Injury Associated with Decreased Compliance of the External Iliac Vein After Laparoscopic Myomectomy}},
  author = {Chen B and Chen H and Tong J and Xu L and Wang Y},
  journal = {International Journal of Women's Health},
  year = {2026},
  month = nov,
  url = {https://www.dovepress.com/case-report-suspected-lower-limb-congestive-injury-associated-with-dec-peer-reviewed-fulltext-article-IJWH},
  note = {CC BY},
}

TY  - JOUR
TI  - Case Report: Suspected Lower Limb Congestive Injury Associated with Decreased Compliance of the External Iliac Vein After Laparoscopic Myomectomy
AU  - Chen B
AU  - Chen H
AU  - Tong J
AU  - Xu L
AU  - Wang Y
PY  - 2026
DA  - 2026/11/08
JO  - International Journal of Women's Health
UR  - https://www.dovepress.com/case-report-suspected-lower-limb-congestive-injury-associated-with-dec-peer-reviewed-fulltext-article-IJWH
AB  - Binyan Chen,1,* Huanqing Chen,1,* Jinyi Tong,2 Lei Xu,3 Yahui Wang2 1The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People’s Hospital, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Obstetrics and Gynecology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Respiratory, Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yahui Wang, Department of Obstetrics and Gynecology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, People’s Republic of China, Email [email protected]: The incidence of lower extremity deep vein thrombosis following gynecologic laparoscopy is 4.0%, whereas postoperative well-leg compartment syndrome (WLCS) is much rarer, with a reported incidence of only 0.03%– 0.20%. Both conditions can present with postoperative lower limb swelling and pain. We report a case of postoperative lower limb swelling and pain that suspected to be caused by venous congestion injury secondary to decreased compliance of the external iliac vein, a condition that has not been previously reported in the literature.Case Presentation: A 44-year-old woman underwent an 8-hour gynecologic laparoscopic procedure in the Lloyd-Davies position. Thirty minutes after surgery, she developed acute swelling, pain, and numbness of the right lower limb. Deep vein thrombosis was initially suspected, but treatment was ineffective. Unilateral well-leg compartment syndrome (WLCS) was subsequently considered, and her symptoms were relieved following supportive treatment, including dehydration therapy and elevation of the affected limb. Repeated review of the surgical video suggested lower limb congestive injury potentially associated with decreased compliance of the external iliac vein. The patient also experienced persistent postoperative symptoms resembling venous intermittent claudication, consistent with the clinical manifestations of impaired external iliac venous outflow.Conclusion: This case highlights the need for increased attention to the condition of the external iliac vascular sheath during gynecologic laparoscopic surgery. Swelling and thickening of the vascular sheath, resulting in decreased compliance of the venous wall, may lead to severe venous congestion injury of the lower limb and may require timely intraoperative intervention when necessary. This case may provide a reference for the clinical diagnosis and management of postoperative lower limb swelling and pain following gynecologic laparoscopic surgery.Keywords: Laparoscopic surgery, surgical complication, the external iliac vein, venous compliance
SN  - 1179-1411
ER  -