Abdominal compartment syndrome - Intra-abdominal hypertension: Defining, diagnosing, and managing

Papavramidis, Theodossis S; Marinis, Athanasios; Pliakos, Ioannis; Κεσίσογλου, Ισαάκ; Papavramidou, Niki

doi:10.4103/0974-2700.82224

Cited by 129 publications

(101 citation statements)

References 114 publications

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“…First, elevated abdominal pressure affects the cardiovascular system by increasing intrathoracic pressure [13], which in caused by reduced hepatic blood flow, and abdominal wall ischemia [11,14]. As shown in Table 1 Table 2 indicated that partial pressure of carbon dioxide was elevated to 42 mmHg, while partial pressure of oxygen had fallen to 121 mmHg.…”

Section: Discussionmentioning

confidence: 99%

“…In the present case, there were no signs of aspiration before or after induction, the bilateral airway entry was auscultated, and neither the tidal volume nor inspiratory gas flow rate were manipulated until PIP increased. In addition, we checked that the breathing circuit was not bent, and confirmed the tube location once again, A perioperative increase of abdominal pressure may have various causes, including hemorrhage, edema, ileus, and abscess [11,12]. Elevated abdominal pressure not only disturbs the local blood flow within the abdominal cavity but also has detrimental effects on non-abdominal organs and systems.…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative ventilation and hemodynamic change due to bladder perforation during transurethral resection of a bladder tumor - A case report -

et al. 2017

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Transurethral resection is a common, effective urologic procedure performed to resolve urinary tract obstruction in benign prostatic hypertrophy, prostate cancer, and bladder cancer. However, its complications include hemorrhage, infection, transurethral resection syndrome (TURS), bladder perforation, urinary tract obstruction, urinary incontinence, and sepsis [1,2]. While bladder perforation occurs in up to 58% of all cases, cases of bladder perforation that require surgical treatment are rare [3,4]. Risk for bladder perforation CASE REPoRTAn 80-year-old male patient (weight 50 kg, height 158 cm) was scheduled to undergo transurethral resection of the bladder (TURB) for multiple masses, including a 3.8-cm mass in the left bladder wall, and prostatic hypertrophy. He had a history of hypertension with no other notable disease history, and had undergone three previous transurethral resection surgeries. Preoperative chest X-ray, pulmonary function test, electrocardiography, and echocardiography findings were normal. Two days before the operation, his hemoglobin and hematocrit counts were reduced to 8. Transurethral resection is the most efficacious and safest urologic procedure for the treatment of benign prostatic hypertrophy, prostate cancer, and bladder cancer. Complications of transurethral resection include hemorrhage, infection, transurethral resection syndrome, and bladder perforation. Early detection of bladder perforation is important because it can cause critical ventilation and hemodynamic changes. In this case, we detected bladder perforation as the cause of ventilation and hemodynamic change intraoperatively and treated it by immediate surgical repair.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intraoperative ventilation and hemodynamic change due to bladder perforation during transurethral resection of a bladder tumor - A case report -

et al. 2017

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“…13 Thus it is advisable every time the closure of the abdominal wall is not possible or determines a high risk of complication with need of relaparotomy. 18 With this kind of operation, revisions allow to identify quickly anastomotic dehiscences or any problem that can occur into the abdomen. 19 Caronna et al hypothesised the usefulness of laparostomy for the early diagnosis and treatment of complications in management of typhoid intestinal perforation in rural hospital in northwestern Benin.…”

Section: Discussionmentioning

confidence: 99%

Laparostomy in a rural hospital: an African case report for a very important tool to be spread and increased

et al. 2017

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Laparostomy is a surgical technique enabling the surgeon to leave abdominal fascial edges opened after a laparotomy. This is a useful tool that can be very important in patients with intraabdominal hypertension. Open abdomen indications are: trauma, severe abdominal sepsis, intestinal infarction, vascular surgery and when the surgeon cannot close the abdomen due to high intra abdominal pressure in order to avoid abdominal compartment syndrome or in case of a second look in order to evaluate the conditions of the abdomen (and particularly of the gut). We used this technique in a low income country for a patient with intestinal obstruction where performing a primary anastomosis during the first operation was at high risk of leakage.A middle-aged woman was admitted in Pope John's Hospital -Aber, Uganda for abdominal pain and intestinal obstruction (IO) symptoms. A laparotomy found a tract of small gut necrotic and twisted under a single adhesion. The small gut above the volvulus was dilated for the obstruction created by the adhesion. We decided to excise the necrotic intestine and leave the abdomen open for a second look and delayed anastomosis and closure. The managing of the IO was conducted by inserting a big Foley catheter in the proximal intestine to drain its enteric content in a similar fashion to a guided external fistula.Open abdomen is a very important technique, relatively new, that can impact positively in treating some surgical patients even in rural hospitals and in the absence of Intensive Care Unit. A simple trick can solve successfully the IO due to the volvulus. Laparostomy should be spread more in African and low-income countries. Case ReportA 42(?)-year old woman came to Aber Hospital at around 7:00 p.m. and was admitted in October 2015 to the surgical ward complaining severe abdominal pain, she was not passing stools and flatus for the past 5 days and she had no history of previous surgeries. The patient was hemodynamically stable, although slightly tachicardic (BP 100/70, HR 100 bpm). Clinically she presented with severe abdominal distension and signs of peritonitis. Rectal exploration was carried out at hospital admission showing empty rectus. We tried to manage this case conservatively by passing a rectal tube thinking it could have been a sigmoid volvulus, very frequent in African communities but after a plain abdominal XR we realized the distension was coming from the small gut. Blood tests showed a mild leukocytosis, normal Hb and PLT. The patient started resuscitation fluids, IV antibiotics, and pain relief, we passed a NGT and urinary catheter. An explorative laparotomy was planned the following day: despite she was slightly peritonitic at presentation, it was impossible to set up the theatre and perform the operation sooner due to logistic deficiency. The NGT output before the operation was about 100 mls and urine output about 1500 mls. The operation was undertaken the following morning, as soon as it was possible to arrange the theatre (around 8:00 a.m.), and the patient's vi...

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“…These set of findings represent the abdominal compartment syndrome caused by massive retroperitoneal and interstitial swelling. 4 In 2004, the World Society of Abdominal Compartment Syndrome (WSACS) was established by an international group of surgeons and physicians. They recognized the need for a cohesive approach fostering education, promoting research, treating and improving the survival of patients suffering from IAH and ACS.…”

Section: Discussionmentioning

confidence: 99%

Perioperative intra-abdominal pressure monitoring in emergency laparotomy

et al. 2017

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Background: The aim of present study is to evaluate the perioperative monitoring of intra-abdominal pressure and abdominal compartment syndrome and its association with the postoperative morbidity in terms of kidney function and pulmonary atelectasis and mortality of the patients undergoing emergency laparotomy.Methods: A prospective study was done in 100 patients undergoing laparotomy. The study was conducted in the department of general surgery, Government Kilpauk medical college and hospital for the period of six months from January 2015 to June 2015. The study group of 100 patients was divided into 2 groups, each group containing 50 patients. The first group containing 50 patients having increased intra-abdominal pressure undergoing emergency laparotomy and second group containing 50 patients undergoing elective laparotomy. The post-operative morbidity in terms of kidney function by means of urea, creatinine and urine output and pulmonary atelectasis with the help of chest x-ray and mortality analyzed compared in between the two groups.Results: By comparing the two groups, the group undergoing emergency laparotomy with increased intra-abdominal pressure had increase in the incidence of postoperative morbidity and mortality than the elective laparotomy group without elevated intra-abdominal pressure.Conclusions: Thus, the perioperative monitoring of intra-abdominal pressure is highly useful in diagnosing intra-abdominal hypertension and abdominal compartment syndrome and thereby helps in minimizing the post-operative morbidity and mortality in emergency laparotomy patients.

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Abdominal compartment syndrome - Intra-abdominal hypertension: Defining, diagnosing, and managing

Cited by 129 publications

References 114 publications

Intraoperative ventilation and hemodynamic change due to bladder perforation during transurethral resection of a bladder tumor - A case report -

Intraoperative ventilation and hemodynamic change due to bladder perforation during transurethral resection of a bladder tumor - A case report -

Laparostomy in a rural hospital: an African case report for a very important tool to be spread and increased

Perioperative intra-abdominal pressure monitoring in emergency laparotomy

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