Decompressive Laparotomy

The study was performed for analysis of current understanding of intra-abdominal hypertension and abdominal compartment syndrome in patients with severe acute pancreatitis.The English and Russian articles about intra-abdominal hypertension and abdominal compartment syndrome in patients with severe acute pancreatitis were analyzed. The articles were found in «Russian Science Citation Index» and «PubMed».There is a pathogenetic relationship between increased intra-abdominal pressure and the development of severe acute pancreatitis.For today, it was shown that intra-abdominal hypertension in patients with severe acute pancreatitis is associated with significantly higher APACHE-II and MODS score, prevalence of pancreatic and peripancreatic tissue lesions, early infection of pancreatic necrosis and higher mortality.The article considers various variants of decompressive interventions such as decompressive laparotomy, fasciotomy and percutaneous catheter drainage. For today, there are no randomized studies devoted to researching effectiveness of different decompressive interventions.The study showed that it is necessary to regularly monitor intra-abdominal pressure in patients with severe acute pancreatitis. Patients with intra-abdominal hypertension require emergency medical management to reduce intra-abdominal pressure. Inefficiency of the medical management and development of abdominal compartment syndrome are indications for surgery. The effectiveness of different decompressive interventions requires further studies.

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Decompressive Abdominal Laparotomy for Abdominal Compartment Syndrome in an Unengrafted Bone Marrow Recipient with Septic Shock

Critical Care Research and Practice ◽

10.1155/2010/102910 ◽

2010 ◽

Vol 2010 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Derrick J. N. Dauplaise ◽

Sean J. Barnett ◽

Jason S. Frischer ◽

Hector R. Wong

Keyword(s):

Bone Marrow ◽

Septic Shock ◽

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Pediatric Intensive Care ◽

Individual Case ◽

Individual Case Report ◽

Decompressive Laparotomy ◽

Massive Fluid ◽

Abdominal Compartment

Objective. To describe a profoundly immunocompromised (panleukopenia) child with septic shock who developed abdominal compartment syndrome (ACS) and was successfully treated with surgical decompression.Design. Individual case report.Setting. Pediatric intensive care unit of a tertiary children's hospital.Patient. A 32-month-old male with Fanconi anemia who underwent bone marrow transplantation (BMT) 5 days prior to developing septic shock secondary toStreptococcus viridansandEscherichia coliACS developed after massive fluid resuscitation, leading to cardiopulmonary instability.Interventions. Emergent surgical bedside laparotomy and silo placement.Measurements and Main Results. The patient's cardiopulmonary status stabilized after decompressive laparotomy. The abdomen was closed and the patient survived to hospital discharge without cardiac, respiratory, or renal dysfunction.Conclusions. The use of laparotomy and silo placement in an unengrafted BMT patient with ACS and septic shock did not result in additional complications. Surgical intervention for ACS is a reasonable option for high risk, profoundly immunocompromised patients.

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Pathophysiology and Management of Abdominal Compartment Syndrome

American Journal of Critical Care ◽

10.4037/ajcc2003.12.4.367 ◽

2003 ◽

Vol 12 (4) ◽

pp. 367-371 ◽

Cited By ~ 50

Author(s):

Jeffrey Walker ◽

Laura M. Criddle

Keyword(s):

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Oxygen Free Radicals ◽

Abdominal Pressure ◽

Decompressive Laparotomy ◽

Abdominal Hypertension ◽

Translocation Of Bacteria ◽

Serial Measurements ◽

Abdominal Compartment ◽

Multiorgan Dysfunction Syndrome

Abdominal compartment syndrome is a potentially lethal condition caused by any event that produces intra-abdominal hypertension; the most common cause is blunt abdominal trauma. Increasing intra-abdominal pressure causes progressive hypoperfusion and ischemia of the intestines and other peritoneal and retroperitoneal structures. Pathophysiological effects include release of cytokines, formation of oxygen free radicals, and decreased cellular production of adenosine triphosphate. These processes may lead to translocation of bacteria from the gut and intestinal edema, predisposing patients to multiorgan dysfunction syndrome. The consequences of abdominal compartment syndrome are profound and affect many vital body systems. Hemodynamic, respiratory, renal, and neurological abnormalities are hallmarks of abdominal compartment syndrome. Medical management consists of urgent decompressive laparotomy. Nursing care involves vigilant monitoring for early detection, including serial measurements of intra-abdominal pressure.

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Abdominal Compartment Syndrome as a Multidisciplinary Challenge. A Literature Review

The Journal of Critical Care Medicine ◽

10.2478/jccm-2018-0024 ◽

2018 ◽

Vol 4 (4) ◽

pp. 114-119 ◽

Cited By ~ 6

Author(s):

Gabriel Alexandru Popescu ◽

Tivadar Bara ◽

Paul Rad

Keyword(s):

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Treatment Guidelines ◽

Surgical Care ◽

Abdominal Pressure ◽

Decompressive Laparotomy ◽

Abdominal Hypertension ◽

Treatment Measures ◽

Points Of View ◽

Abdominal Compartment

Abstract Abdominal Compartment Syndrome (ACS), despite recent advances in medical and surgical care, is a significant cause of mortality. The purpose of this review is to present the main diagnostic and therapeutic aspects from the anesthetical and surgical points of view. Intra-abdominal hypertension may be diagnosed by measuring intra-abdominal pressure and indirectly by imaging and radiological means. Early detection of ACS is a key element in the ACS therapy. Without treatment, more than 90% of cases lead to death and according with the last reports, despite all treatment measures, the mortality rate is reported as being between 25 and 75%. There are conflicting reports as to the importance of a conservative therapy approach, although such an approach is the central to treatment guidelines of the World Society of Abdominal Compartment Syndrome, Decompressive laparotomy, although a backup solution in ACS therapy, reduces mortality by 16-37%. The open abdomen management has several variants, but negative pressure wound therapy represents the gold standard of surgical treatment.

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Decompressive laparotomy for abdominal compartment syndrome in patient on extracorporeal life support: A first survival case among adults with literature review

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907917747075 ◽

2017 ◽

Vol 25 (3) ◽

pp. 166-168

Author(s):

Won Ho Chang

Keyword(s):

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Life Support ◽

Perfusion Pressure ◽

Extracorporeal Life Support ◽

Bladder Pressure ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Decompressive Laparotomy ◽

Abdominal Compartment ◽

Survival Case

Here, we report a case of successful treatment for a patient with abdominal compartment syndrome who was on venoarterial extracorporeal life support. A 33-year-old man visited the emergency room with cardiac arrest. Extracorporeal cardiopulmonary resuscitation was performed, and massive volume infusion was needed to maintain adequate perfusion pressure. After 6 h, his abdomen was distended, and venous drain was decreased. His bladder pressure was more than 25 mm Hg. Abdominal compartment syndrome was suspected, and prompt decompressive laparotomy was performed to restore venous drain, resulting in stabilization hemodynamically. The patient made a full recovery. He was discharged after implantation of internal cardiac defibrillator.

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