Trocar injury of the retroperitoneal vessels followed by life-threatening postischemic compartment syndrome of both lower extremities.

Background: Lesions of the intra-abdominal organs and vessels caused by trocars and Verres needles are rare but serious complications during laparoscopic surgery.

Methods: We report an unusual case of left common iliac artery and inferior vena cava injury during laparoscopy. This lesion was followed by a bilateral postischemic compartment syndrome of the lower extremities. The patient sustained massive rhabdomyolysis, renal failure, peroneal nerve palsy, and functional loss of the lower extremities.

Conclusions: Postischemic tissue swelling should be recognized as early as possible because it is a life-threatening condition that necessitates immediate treatment.