scholarly journals To close or not to close? Treatment of abdominal compartment syndrome by neuromuscular blockade without laparostomy

2010 ◽  
Vol 92 (7) ◽  
pp. e8-e9 ◽  
Author(s):  
J Davies ◽  
A Aghahoseini ◽  
J Crawford ◽  
DJ Alexander
Keyword(s):  
Compartment Syndrome ◽  
Neuromuscular Blockade ◽  
Abdominal Compartment Syndrome ◽  
Gold Standard ◽  
Standard Treatment ◽  
Surgical Decompression ◽  
Successful Management ◽  
Abdominal Compartment ◽  
Prolonged Neuromuscular Blockade ◽  
Nasogastric Decompression

Abdominal compartment syndrome (ACS) is a recognised postoperative complication seen frequently in the intensive care unit (ICU). Surgical decompression and laparostomy remain the gold standard treatment for established ACS, combined with supportive non-surgical therapy, such as nasogastric decompression. In the following case report, we describe our successful management of a patient with established postoperative ACS by re-laparotomy to exclude a reversible cause, immediate re-closure of the abdomen and prolonged neuromuscular blockade, avoiding a laparostomy.

scholarly journals Intra-abdominal hypertension and abdominal compartment syndrome in critically ill patients: A narrative review of past, present, and future steps

2021 ◽  
pp. 145749692110301
Author(s):  
Marije Smit ◽  
Matijs van Meurs ◽  
Jan G. Zijlstra
Keyword(s):  
Compartment Syndrome ◽  
Critically Ill ◽  
Abdominal Compartment Syndrome ◽  
Critically Ill Patients ◽  
Open Abdomen ◽  
Surgical Decompression ◽  
Abdominal Pressure ◽  
Pressure Monitoring ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Background and objective: Intra-abdominal hypertension is frequently present in critically ill patients and is an independent predictor for mortality. In this narrative review, we aim to provide a comprehensive overview of current insights into intra-abdominal pressure monitoring, intra-abdominal hypertension, and abdominal compartment syndrome. The focus of this review is on the pathophysiology, risk factors and outcome of intra-abdominal hypertension and abdominal compartment syndrome, and on therapeutic strategies, such as non-operative management, surgical decompression, and management of the open abdomen. Finally, future steps are discussed, including propositions of what a future guideline should focus on. Conclusions: Pathological intra-abdominal pressure is a continuum ranging from mild intra-abdominal pressure elevation without clinically significant adverse effects to substantial increase in intra-abdominal pressure with serious consequences to all organ systems. Intra-abdominal pressure monitoring should be performed in all patients at risk of intra-abdominal hypertension. Although continuous intra-abdominal pressure monitoring is feasible, this is currently not standard practice. There are a number of effective non-operative medical interventions that may be performed early in the patient’s course to reduce intra-abdominal pressure and decrease the need for surgical decompression. Abdominal decompression can be life-saving when abdominal compartment syndrome is refractory to non-operative treatment and should be performed expeditiously. The objectives of open abdomen management are to prevent fistula and to achieve delayed fascial closure at the earliest possible time. There is still a lot to learn and change. The 2013 World Society of Abdominal Compartment Syndrome guidelines should be updated and multicentre studies should evaluate the effect of intra-abdominal hypertension treatment on patient outcome.

scholarly journals Abdominal compartment syndrome caused by gastric distension in bulimia nervosa and fatal injury following surgical decompression - A case report -

2020 ◽  
Vol 15 (2) ◽  
pp. 251-258
Author(s):  
Byeong hun Eom ◽  
Hyun Kyoung Lim ◽  
Nayoung Tae ◽  
Helen Ki Shinn
Keyword(s):  
Bulimia Nervosa ◽  
Reperfusion Injury ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Color Change ◽  
Ischemia Reperfusion ◽  
Abdominal Cavity ◽  
Surgical Decompression ◽  
Gastric Distension ◽  
Abdominal Compartment

Background: Abdominal compartment syndrome (ACS) occurs due to increased abdominal cavity pressure, causes multiple organ damage, and leads to fatal consequences. Increased intraperitoneal pressure due to different reasons generally does not result in serious damage, due to the compliance of the abdominal wall. However, when the pressure exceeds the limit, ACS develops, thereby causing fatal damage to the organs. Case: A patient presented with rapid stomach swelling due to excessive food intake and was known to have bulimia nervosa, which had now resulted in ACS. Mental changes, abdominal distension, color change in the legs, acute kidney injury, and acidosis were seen. The patient expired due to ischemia-reperfusion injury and disseminated intravascular coagulation, which occurred after surgical decompression.Conclusions: Under suspected ACS conditions, we should be aware of various symptoms that can occur. Early attempts for decompression are helpful, and it is important to be prepared for reperfusion injury prior to surgical decompression attempts.

scholarly journals Abdominal Compartment Syndrome Caused by Massive Pyonephrosis in an Infant with Primary Obstructive Megaureter

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Silvia K. Kavaguti ◽  
Barbara R. Mackevicius ◽  
Murilo F. de Andrade ◽  
Silvio Tucci Jr ◽  
Ana P. C. P. Carlotti
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Surgical Decompression ◽  
Obstructive Megaureter ◽  
Abdominal Compartment

The authors report a case of abdominal compartment syndrome caused by massive pyonephrosis in an infant with primary obstructive megaureter successfully treated with emergency surgical decompression.

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