scholarly journals Non-ICU-Based Staged Management of Laparotomy-Related Abdominal Compartment Syndrome in a 23-Year-Old Male

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Kofi Tawiah Mensah

Introduction: Abdominal compartment syndrome (ACS) is a sustained intraabdominal pressure (IAP) of 20 mmHg or higher with new organ dysfunction. Decompression is required when IAP exceeds 25 mmHg even without evidence of organ dysfunction. Common abdominal surgical diseases and operations can be complicated by ACS, and clinicians should have the requisite capacity to detect and intervene early enough. Intensive care unit (ICU) care has traditionally been the mainstay of ACS management. Case Presentation: A 23-year-old male was referred with a combined mesh and Bogota bag anterior abdominal construct after a midline laparotomy 24 hours earlier, following which the abdominal wall could not be closed primarily without tension. This was the result of significant edema of the bowel and retroperitoneum. This patient, after adequate resuscitation, underwent a two-staged procedure, 6 days apart, to achieve skin closure. After an unremarkable skin healing, a mesh repair for the consequent incisional hernia was carried out 15 months later. Conclusions: This patient’s ACS was successfully managed in a non-ICU setting and could demonstrate the possibility of successfully managing selected cases of laparotomy-related ACS in low-resource settings without ICU facilities.

2019 ◽  
Vol 2 (1) ◽  
pp. 35-40
Author(s):  
Daniel Ion ◽  
Dan Nicolae Păduraru ◽  
Florentina Mușat ◽  
Octavian Andronic ◽  
Alexandra Bolocan

AbstractThe clinical signs and symptoms of an acute in increase intraabdominal pressure (IAP) are subtle, especially in the conditions of the polytraumatized patient. Thus, abdominal compartment syndrome (ACS) can brutally occur and can have a major impact on the body’s main organs and systems. The purpose of our research was to identify the influence of intraabdominal pressure, intra-abdominal hypertension, and abdominal compartment syndrome, in the evolution of polytraumatized patients. Our study analyzed the patients admitted in the IIIrd Department of General Surgery of University Emergency Hospital in Bucharest between 1st of January 2010 and 31st of December 2018. The value of intraabdominal pressure, on admission, correlated with the risk of IAH/ ACS in patients with abdominal trauma - being major causes of morbidity and mortality. IAP monitoring should become a mandatory part of the management plan for patients with abdominal trauma.


2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
J. Chiaka Ejike ◽  
Jennifer Newcombe ◽  
Joanne Baerg ◽  
Khaled Bahjri ◽  
Mudit Mathur

Background. The sparse reporting of abdominal compartment syndrome (ACS) in the pediatric literature may reflect inadequate awareness and recognition among pediatric healthcare providers (HCP).Purpose. To assess awareness of ACS, knowledge of the definition and intraabdominal pressure (IAP) measurement techniques used among pediatric HCP.Method. A written survey distributed at two pediatric critical care conferences.Results. Forty-seven percent of 1107 questionnaires were completed. Participants included pediatric intensivists, pediatric nurses, and others. Seventy-seven percent () of participants had heard of ACS. Only 46.8% defined ACS correctly. The threshold IAP value used to define ACS was variable among participants. About one-quarter of participants (83/343), had never measured IAP.Conclusion. Twenty-three percent of HCP surveyed were unaware of ACS. Criteria used to define ACS were variable. Focused education on recognition of ACS and measuring IAP should be promoted among pediatric HCP.


2010 ◽  
Vol 203 (2) ◽  
pp. 149.e1-149.e4 ◽  
Author(s):  
Sonya S. Abdel-Razeq ◽  
Katherine Campbell ◽  
Edmund F. Funai ◽  
Lewis J. Kaplan ◽  
Mert Ozan Bahtiyar

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Helene Flageole ◽  
Jodie Ouahed ◽  
J. Mark Walton ◽  
Yasmin Yousef

Abdominal compartment syndrome (ACS) is defined as an elevated intraabdominal pressure with evidence of organ dysfunction. The majority of published reports of ACS are in neonates with abdominal wall defects and in adults following trauma or burns, but it is poorly described in children. We describe the unusual presentation of an 11-year-old boy with a long history of chronic constipation who developed acute ACS requiring resuscitative measures and emergent disimpaction. He presented with a 2-week history of increasing abdominal pain, nausea, diminished appetite and longstanding encopresis. On exam, he was emaciated with a massively distended abdomen with a palpable fecaloma. Abdominal XR confirmed these findings. Within 24 hours of presentation, he became tachycardic and oliguric with orthostatic hypotension. Following two enemas, he acutely deteriorated with severe hypotension, marked tachycardia, acute respiratory distress, and a declining mental status. Endotracheal intubation, fluid boluses, and vasopressors were commenced, followed by emergent surgical fecal disimpaction. This resulted in rapid improvement in vital signs. He has been thoroughly investigated and no other condition apart from functional constipation has been identified. Although ACS secondary to constipation is extremely unusual, this case illustrates the need to actively treat constipation and what can happen if it is not.


Author(s):  
Daniel J. Johnson

In abdominal compartment syndrome (ACS), a fixed compartment (the abdomen with defined myofascial elements) is subjected to increased pressure. The result is decreased organ perfusion and subsequent dysfunction inside the abdominal cavity and the respiratory and cardiovascular systems. Given the affect of treatment for organ dysfunction, an accurate characterization of primary illness progression and ACS is crucial for diagnostic assessment.


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