Introduction Abdominal compartment syndrome is a life-threatening condition that affects critically ill patients. When pressures inside a fixed cavity of the body increases, ischemia, muscle injury, and organ failure can result. Aim To assess the benefits and outcomes of laparostomy for abdominal compartment syndrome. Methods This retrospective study included patients who underwent a laparostomy procedure as a treatment measure for abdominal compartment syndrome, secondary to different etiologies such as sepsis and major abdominal visceral trauma. Results Although there are a few complications such as incisional hernia in the future following a laparostomy, the mortality rate following the procedure is less than < 10%, thus ensuring a good prognosis for patients who present with acute surgical emergencies. It could also be further noted that an early closure by 7 to 14 days had definite beneficial outcomes as compared with delayed closure of more than 14 days. It prevented most long-term complications such as entero-atmospheric fistula formation or granuloma formation, the outcomes of which were further aided by the use of a transparent custom-made polypropylene mesh. Conclusion Laparostomy is the gold standard treatment for abdominal compartment syndrome. The use of a custom-made polypropylene mesh has proven to have the least complications in the follow-up period. Incisional hernias are the most common complications documented, followed by entero-atmospheric fistula.

Primary peritonitis is a condition in which there is no intraabdominal source of infection demonstrated during laparotomy. It is uncommon and can affect any age group from childhood to the elderly. We report here a case of Primary peritonitis with septic shock as a presenting feature, associated with empyema thoracis. This combination was not reported previously in the literature. Our patient was a 15-yr old girl with a ten day history of fever, cough, dyspnea, abdominal pain and loose stools initially treated elsewhere. She was brought to the emergency in a gasping state, bradycardia, hypotension, tachypnoea and a distended abdomen. She was intubated, resuscitated and a bedside ultrasound revealed free fluid present all over peritoneal cavity. Emergency laparotomy under general anesthesia showed extensive thick yellow coloured nonfoul-smelling purulent fluid all over the peritoneal spaces with distended bowel loops. A thorough search confirmed no evidence of hollow-viscus perforation, peritoneal lavage, appendicectomy and laparostomy were done. Postoperatively she was ventilated electively and managed in a high dependency care unit with broad spectrum antibiotics and respiratory supportive measures. However she continued to have high fever, tachycardia, tachypneic and developed left massive pyothorax. Thoracoscopic drainage of the flakes of pus in the pleural cavity with extensive decortication done. Then, once her sepsis was well controlled, underwent laparostomy closure. However, post laparostomy-closure had signs of LV dysfunction with respiratory failure and managed with cardiac drugs. She had a turbulent postoperative course, gradually recovered, and was discharged home after nine weeks of admission.

Uterine perforation followed by transmigration of intrauterine contraceptive device to the abdominal cavity is one of the rarest, but most dangerous complication of Copper T. These displaced Copper containing devices can cause chronic inflammatory reaction leading to adhesions, intestinal obstruction and even bowel perforation. Hence removal of these devices once found outside the uterus is recommended. Traditionally, a laparotomy used to be performed owing to the associated inflammation, adhesions and the risks of bowel injury. Laparoscopic removal of these displaced devices is a minimally invasive surgical approach with good results in skilled hands. Authors reported a rare case of misplaced transmigrated intrauterine contraceptive device in a 43-year-old asymptomatic lady. The Copper T had migrated after silent perforation of the uterus and was impacted in the greater omentum. There was evidence of chronic inflammation and small pockets of pus surrounding it. There were flimsy bowel adhesions. The dislodged device was successfully removed laparoscopically along with partial omentectomy without any complications. Regular follow up of patients who have had Copper T insertions and teaching them to feel the thread and report if not felt is essential to diagnose complications early. A transmigrated intrauterine device can be successfully removed laparoscopically.