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

Eom, Byeong Hun; Lim, Hyun Kyoung; Tae, Nayoung; Shinn, Helen Ki

doi:10.17085/apm.2020.15.2.251

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…This may be indicative and likely for translation, as reperfusion syndrome in patients can frequently occur during decompression surgery and be a cause of death. It was claimed that no therapeutic approach could improve the progression of the syndrome by itself [65][66][67][68]. On the other hand, the cytoprotection background and maintenance and/or recovery of endothelium function [1][2][3][30][31][32][33][34] in favor of this study (reperfusion-induced vascular and multiorgan failure, and occlusion/occlusion-like syndrome as a whole, strongly counteracted by BPC 157 therapy) provided a large beneficial range of effects of BPC 157 therapy that can be likely extended from the previous studies [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…With conceptual notification that vascular rescue rapidly occurs in cytoprotection [36], the significance appears consistently [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. This would be prompt counteraction with rapid vessel recovery, ensuring the prompt capability of the vessels to take full blood flow and avoid (or stop) an otherwise imminent course (increased permeability, massive hemorrhage leading hypotension, cardiac failure, and arrhythmias) resulting in high mortality in patients [65][66][67][68].…”

Section: Discussionmentioning

confidence: 99%

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Stable Gastric Pentadecapeptide BPC 157 Therapy: Effect on Reperfusion Following Maintained Intra-Abdominal Hypertension (Grade III and IV) in Rats

Tepes,

Krezic,

Vranes

et al. 2023

Pharmaceuticals

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Given in reperfusion, the use of stable gastric pentadecapeptide BPC 157 is an effective therapy in rats. It strongly counteracted, as a whole, decompression/reperfusion-induced occlusion/occlusion-like syndrome following the worst circumstances of acute abdominal compartment and intra-abdominal hypertension, grade III and grade IV, as well as compression/ischemia-occlusion/occlusion-like syndrome. Before decompression (calvariectomy, laparotomy), rats had long-lasting severe intra-abdominal hypertension, grade III (25 mmHg/60 min) (i) and grade IV (30 mmHg/30 min; 40 mmHg/30 min) (ii/iii), and severe occlusion/occlusion-like syndrome. Further worsening was caused by reperfusion for 60 min (i) or 30 min (ii/iii). Severe vascular and multiorgan failure (brain, heart, liver, kidney, and gastrointestinal lesions), widespread thrombosis (peripherally and centrally) severe arrhythmias, intracranial (superior sagittal sinus) hypertension, portal and caval hypertension, and aortal hypotension were aggravated. Contrarily, BPC 157 therapy (10 µg/kg, 10 ng/kg sc) given at 3 min reperfusion times eliminated/attenuated venous hypertension (intracranial (superior sagittal sinus), portal, and caval) and aortal hypotension and counteracted the increases in organ lesions and malondialdehyde values (blood ˃ heart, lungs, liver, kidney ˃ brain, gastrointestinal tract). Vascular recovery promptly occurred (i.e., congested inferior caval and superior mesenteric veins reversed to the normal vessel presentation, the collapsed azygos vein reversed to a fully functioning state, the inferior caval vein–superior caval vein shunt was recovered, and direct blood delivery returned). BPC 157 therapy almost annihilated thrombosis and hemorrhage (i.e., intracerebral hemorrhage) as proof of the counteracted general stasis and Virchow triad circumstances and reorganized blood flow. In conclusion, decompression/reperfusion-induced occlusion/occlusion-like syndrome counteracted by BPC 157 therapy in rats is likely for translation in patients. It is noteworthy that by rapidly counteracting the reperfusion course, it also reverses previous ischemia-course lesions, thus inducing complete recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stable Gastric Pentadecapeptide BPC 157 Therapy: Effect on Reperfusion Following Maintained Intra-Abdominal Hypertension (Grade III and IV) in Rats

Tepes,

Krezic,

Vranes

et al. 2023

Pharmaceuticals

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“…Most prior studies of the progression of AGD to ACS have reported unfavorable outcomes. [9,[19][20][21] Decompression is insufficient in cases where the food materials or other particles inside the stomach are larger than the hole at the tip of the NG tube. Autopsy studies have revealed that gastric volvulus or direct compression of the upper GI tract by the distended stomach is a crucial cause of death in ACS with AGD.…”

Section: Discussionmentioning

confidence: 99%

Abdominal compartment syndrome caused by severe acute gastric distension in a patient with COVID-19: A case report

Park

Nho

2023

Medicine

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Rationale: The clinical manifestation of coronavirus disease 2019 (COVID-19) ranges from asymptomatic to critical. The gastrointestinal (GI) tract is involved in the early stages of the disease and is recognized as an important entry site for the virus. Consequently, GI manifestations are common in patients with COVID-19; however, the GI presentation of COVID-19 in relation to bowel dilatation has rarely been reported. Here, we report a case of acute severe gastric distension resulting in aortic compression and abdominal compartment syndrome (ACS) in a patient with COVID-19. Patient concerns: A 72-year-old male presented to the emergency department (ED) with severe abdominal distension. The patient had been confirmed to have COVID-19 5 days prior to the visit. Diagnoses: Computed tomography revealed critical abdominal distension with severe gastric dilatation, accompanied by compression of the abdominal aorta and distal thrombosis formation. Interventions: Intravenous fluid resuscitation and support with inotropic agents were initiated immediately, and a large amount of gastric content was evacuated via a nasogastric (NG) tube. Outcome: Finally, the patient was discharged after 12 days of admission without obvious complications. Lessons: ACS is critical, which can be caused by a severe degree of acute gastric distension (AGD). Evacuation of the intraluminal contents is the most efficient management strategy. Prognosis is poor, and most previous studies of the transition from AGD to ACS have reported unfavorable outcomes.

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Abdominal Compartment Syndrome Secondary to Bulimia Nervosa: A Case Report and Systematic Review of Published Cases

Olojede,

Cassimatis,

Tsao

2024

The Journal of Emergency Medicine

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

Cited by 3 publications

References 12 publications

Stable Gastric Pentadecapeptide BPC 157 Therapy: Effect on Reperfusion Following Maintained Intra-Abdominal Hypertension (Grade III and IV) in Rats

Stable Gastric Pentadecapeptide BPC 157 Therapy: Effect on Reperfusion Following Maintained Intra-Abdominal Hypertension (Grade III and IV) in Rats

Abdominal compartment syndrome caused by severe acute gastric distension in a patient with COVID-19: A case report

Abdominal Compartment Syndrome Secondary to Bulimia Nervosa: A Case Report and Systematic Review of Published Cases

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