The association of perinatal and clinical factors with outcomes in infants with gastroschisis—a retrospective multicenter study in Finland

AbstractThe aim of the present study was to assess the prognostic factors for the outcome of gastroschisis in Finland. A retrospective multicenter study of gastroschisis patients born between 1993 and 2015 in four Finnish university hospitals was undertaken, collecting perinatal, surgical, and clinical data of neonates for uni- and multifactorial modeling analysis. The aim of the present study was to identify risk factors for mortality and the composite adverse outcome (death and/or short bowel syndrome or hospital stay > 60 days). Of the 154 infants with gastroschisis, the overall survival rate was 90.9%. In Cox regression analysis, independent risk factors for mortality included liver herniation, pulmonary hypoplasia, relaparotomy for perforation or necrosis, abdominal compartment syndrome, and central line sepsis. Furthermore, a logistic regression analysis identified central line sepsis, abdominal compartment syndrome, complex gastroschisis, and a younger gestational age as independent predictors of the composite adverse outcome.Conclusion: The risk of death is increased in newborns with gastroschisis who have liver herniation, pulmonary hypoplasia, abdominal compartment syndrome, relaparotomy for perforation or necrosis, or central line–associated sepsis. Special care should be taken to minimize the risk of central line sepsis in the clinical setting. What is known:• Gastroschisis is a relatively rare congenital anomaly of the abdominal wall and its incidence is increasing.• Complex gastroschisis has been reported to increase risk of mortality and complications.What is new:• Central line sepsis was found to be independently associated with mortality in gastroschisis patients.• Liver herniation was also significantly associated with mortality.

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Risk Factors in Abdominal Emergency Surgery Responsible for The Development of Abdominal Compartment Syndrome

10.36295/asro.2020.231408 ◽

2020 ◽

Vol 23 (14) ◽

Author(s):

Hassan Abdulmaged Abdulhameed Al-Gburi ◽

Ammar Fouad Abdulrazaq ◽

Mohammad Faraj Dawod Al.Jafary

Keyword(s):

Risk Factors ◽

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Emergency Surgery ◽

Abdominal Emergency ◽

Abdominal Compartment

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Risk Factors for the Development of Intra-Abdominal Hypertension and Abdominal Compartment Syndrome after Complex Ventral Hernia Repair: A Case Series of 175 Consecutive Patients

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2018.08.312 ◽

2018 ◽

Vol 227 (4) ◽

pp. e115

Author(s):

Raghav Chandra ◽

Richard A. Jacobson ◽

Keith W. Millikan ◽

Jennifer Poirier ◽

Nicole Siparsky

Keyword(s):

Risk Factors ◽

Hernia Repair ◽

Compartment Syndrome ◽

Ventral Hernia ◽

Abdominal Compartment Syndrome ◽

Ventral Hernia Repair ◽

Case Series ◽

Complex Ventral Hernia ◽

Abdominal Hypertension ◽

Abdominal Compartment

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Abdominal compartment syndrome due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-020-02566-8 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Daisuke Usuda ◽

Kohei Takanaga ◽

Ryusho Sangen ◽

Toshihiro Higashikawa ◽

Shinichi Kinami ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Neuropathy ◽

Compartment Syndrome ◽

Sigmoid Colon ◽

Abdominal Compartment Syndrome ◽

Fecal Impaction ◽

Abdominal Pressure ◽

Review Of The Literature ◽

Colon And Rectum ◽

Abdominal Compartment

Abstract Background Abdominal compartment syndrome (ACS) is defined as a sustained raised level of intra-abdominal pressure more than 20 mmHg with or without abdominal perfusion pressure less than 60 mmHg and the development of new end-organ failure. Abdominal surgery, major trauma, volvulus, ileus, distended abdomen, fecal impaction, acute pancreatitis, liver dysfunction, sepsis, shock, obesity, and age have all been reported as risk factors. Herein, we report the severest known case of ACS due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy, together with a brief review of the literature. Case presentation A 48-year-old Asian man suffering from shock was transported by ambulance to our hospital. His medical history included hypoglycemic encephalopathy sequelae, disuse syndrome, type 2 diabetic neuropathy, and constipation. He recovered consciousness in the ambulance, and his physical examination as well as laboratory findings were normal. X-ray and dynamic computed tomography revealed a thickened gut wall, and an extremely dilated sigmoid colon and rectum filled with a massive amount of stool as well as gas, compressing other intra-abdominal organs. We diagnosed the patient with transient vasovagal syncope, together with ACS, due to extremely elongated sigmoid colon and rectum plus fecal impaction, caused by anorectal disturbance derived from disuse syndrome and diabetic neuropathy. We first repeated stool extraction for bowel decompression and he subsequently became symptom-free, after which we performed a colostomy on the 28th hospital day. The postoperative course was uncomplicated, and he was discharged on the 44th hospital day. Conclusions Clinicians need to keep ACS in mind as a differential diagnosis and perform careful and detailed examination when encountering patients presenting with symptoms or risk factors of ACS. In addition, they need to precisely diagnose ACS and perform optimal treatment without delay.

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