Abstract
Acute compartment syndrome (ACS) is defined as a severe rise in pressure within a fascial compartment thereby leading to impaired microvascular perfusion of the limb. Therefore, ACS is a surgical emergency and if not treated immediately, permanent neurovascular and muscular compromise can ensue. When compartment syndrome is suspected, clinical recognition and timely assessment of the limb is essential to preventing limb ischemia. The classic cause of ACS is trauma; however, coagulopathies have been known to incite these events. Hemorrhage into a compartment can cause ACS but is rare in the literature. Here we present a case of thrombophilia resulting from pathological liver disease, leading to ACS that ultimately led to limb exsanguination. Education on early recognition of liver disease as an indirect underlying cause of ACS is imperative in order to prevent the dangerous sequelae that follow ACS.