Expert: Dr Ian Jackson - please note UK based - 3/20/2007

Question
QUESTION: My husband has had an enlarged left calf muscle since 1996. This happened during his  apendectomy operation.He woke up and had a major charlie horse in his calf. He has had it sonogramed in 96 and looked at over the years. Last year had an MRI.Doctors never seemed too concerned till now. He has had body work treatments, nothing has made it better. He is a builder. The more he stands and exercises the larger and sorer it gets. He is 48. A chiropractor wants him to see a Vascular doctor asap. He will see one next week. Can this be a result from the  Anesthesia or operation
ANSWER: Susan
That is an interesting question.
It is difficult to see how the anaesthetic could have caused him to have an enlarged calf muscle - unless the muscle ruptured as a result of the contractions caused by the muscle relaxant suxamethonium. However that seems very tenuous possibility and is not something I have heard of. However if a muscle like the calf muscle has a major rupture then the part affected contracts into a muscular lump that could possibly explain what you have described.
The position the patient lies in for this operation tends to be very neutral and again should not have caused any problems. It is difficult to imagine anything that the surgeon did in his tummy having an effect on his leg.
As he has been investigated including an MRI then I assume that they have not found any particular reason for his problem? Given that then it is unlikely that the chiropractor has found anything that a vascular doctor will be interested in - however it is important to follow these things through.
So I am puzzled, you do not mention what the doctors have said the cause was, but they must have given you some ideas. I can only guess and give somewhat wild suggestions on the basis of the information I have.
I hope all goes well.
Kind regards
Dr Ian Jackson


---------- FOLLOW-UP ----------

QUESTION: The chiropractor was alarmed when he saw his leg. Calf is 2x size of right calf. It has been like that for 11 years. MRI shows fatty deposits? What caused damage and what it is is still unanswered. He has constant pain in calf. Calf muscle is hard as a rock. They made him walk around after the operation even though he complained of sore calf.Can it be vascular or muscular damage?

Answer
Susan
On the basis of what you have just said the chiropractor is merely repsonding to something he thinks is an acute problem - when you and your husband know it has been like that for many years.
The only other thing I can think of is that he had some degree of blood flow problem to his calf muscle during the operation and that this caused the damage to the muscle. It sounds like muscular damage but I cannot say what caused it. Sorry I can't shed more light on the issue.
I suspect the vascular surgeon won't be able to help much but you never know.
Ian