Abdominal compartment syndrome: Often overlooked conditions in medical intensive care units

Rajasurya, Venkat; Surani, Salim

doi:10.3748/wjg.v26.i3.266

Cited by 52 publications

(62 citation statements)

References 44 publications

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“…In our patient, acute ACS developed as a result of the following risk factors: large fluid resuscitation, acidosis, presence of ascites, and sepsis, with subsequent multiorgan failure [16]. As seen in our patient, deterioration can be rapid if undiagnosed and untreated, leading to acute peritonitis and death [4].…”

Section: Discussionmentioning

confidence: 51%

“…In this case, given the rapid clinical deterioration and unresponsiveness to conservative measures, surgical resection became necessary with good patient outcomes [20]. Furthermore, rapid development of ACS, requires surgical decompression [16]. To our knowledge, this is only the sixth reported case of PG following routine endoscopic surveillance and random simple biopsy as part of a workup for anemia, and the only case reported with acute ACS as a complication [4][5][6][7].…”

Section: Discussionmentioning

confidence: 86%

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Phlegmonous gastritis complicated by abdominal compartment syndrome: a case report

Modares

Tabari

2021

BMC Surg

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Background Phlegmonous gastritis (PG) is a rare, suppurative bacterial infection of the gastric wall, which may rapidly evolve into fatal septicemia. The etiology and pathogenesis are poorly understood; however, multiple risk factors have been cited in current literature. Most cases have been diagnosed at autopsy, and occasionally at laparotomy, as the clinical presentation is often variable. Case presentation We report a case of a 67-year-old male presenting with intractable nausea, vomiting, and epigastric pain following an uneventful upper gastrointestinal (GI) endoscopy. Diagnostic workup including contrast tomography (CT) and endoscopic assessment was in keeping with PG. This was subsequently followed by development of abdominal compartment syndrome (ACS) and clinical deterioration necessitating surgical resection of the stomach. Conclusion This case emphasizes the importance of early diagnosis of this potentially fatal infection that can follow endoscopic procedures and illustrates ACS and septic shock as serious complications. There is currently no consensus on the proper management of PG; however, in this case, a combination of surgery and antibiotics provided a favourable outcome. Limited number of cases of PG have been reported in literature, and to our knowledge, this is the first reported case of PG with subsequent ACS as an acute complication.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 86%

Phlegmonous gastritis complicated by abdominal compartment syndrome: a case report

Modares

Tabari

2021

BMC Surg

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“…6,20 This formula is often used in medical physiology and rehabilitation medicine, helping us understand many common clinical pathophysiological mechanisms, such as erection of the penis, uterine delivery, compartment syndrome, and peripheral edema and can also help us carry out several medical operations, such as promoting bladder emptying, lumbosacral orthosis, laparoscopic surgery, edema control, etc. 6,20,21 In addition, the "gold standard" of measuring the intra-abdominal pressure by measurement of intravesical pressure is also based on this principle. 5,22 The accurate assessment of abdominal compliance is mainly calculated by the Laplace Law, that is, pressure = (2 × thickness × tension)/radius.…”

Section: Discussionmentioning

confidence: 99%

“…Perhaps because the muscle layer plays a major role in the AWT, the AWT is not directly related to the degree of obesity but has individual differences. 21 The reason for the higher AWT in obese patients might be related to the reduction in shaping ability caused by high IAV and the increase in IAP in the resting state caused by gravity of the abdominal wall, and no correlation between the thickness of the rectus abdominis and AC was found in obese patients. 30 In contrast, the possibility that patients with less fat may exercise more abdominal muscles and have a higher AWT cannot be ruled out.…”

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confidence: 93%

A New Device for Measuring Abdominal Wall Tension and Its Value in Screening Abdominal Infection

Tang

Liu

et al. 2021

MDER

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Objective: This study is the largest clinical study of noninvasive Abdominal wall tension (AWT) measurement with a tensiometer to date. It also initially applies a polynomial regression equation to analyze the correlation between AWT measurement and intravesical pressure (IVP) measurement and remarkably finds interesting changes between different IVP intervals and AWT. Methods: Critically ill patients who were treated in the intensive care unit (ICU) of Daping Hospital, Army Medical University, from August 30, 2018, to June 30, 2020, and met the inclusion criteria were prospectively included in this study. The patients were divided into an intra-abdominal hypertension group and a non-intra-abdominal hypertension group and an abdominal infection group and no abdominal infection group. AWT and IVP were measured at 9 points on the abdominal wall on the first day after admission to the ICU. The correlations between AWTs and IVP were analyzed, and the role of AWT in the diagnosis of complications of abdominal infection and the prediction of adverse prognosis were analyzed. Results: A total of 127 patients were included. The average AWT and IVP were 2.77±0.38 N/mm and 12.31±7.01 mmHg, respectively, on the first day of admission. There was a positive correlation between AWT and IVP (correlation coefficient r = 0.706, p < 0.05). The polynomial regression model was AWT= -1.616×10 −3 IVP 2 +8.323×10 −2 IVP+2.094. The cutoff value of the sensitivity and specificity of AWT for the diagnosis of abdominal infection was 2.57 N/mm. Furthermore, AWT = 2.57 N/mm had the best diagnostic efficiency, which was better than that of IAH and lactate. Conclusion:There was a correlation between AWT and IVP. AWT measurement was helpful in the diagnosis of IAH and abdominal infection complications and can therefore serve as a new method for the clinical diagnosis of IVP and abdominal infection.

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“…Recurrent ACS is the development of IAH or ACS after a previously treated primary or secondary ACS. This can present even in an open abdomen or after closure and resolution of the initial ACS episode[ 2 , 12 ].…”

Section: Definitionsmentioning

confidence: 99%

Abdominal compartment syndrome among surgical patients

León¹,

Chavez²,

Surani³

2021

WJGS

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Abdominal compartment syndrome (ACS) develops when organ failure arises secondary to an increase in intraabdominal pressure. The abdominal pressure is determined by multiple factors such as blood pressure, abdominal compliance, and other factors that exert a constant pressure within the abdominal cavity. Several conditions in the critically ill may increase abdominal pressure compromising organ perfusion that may lead to renal and respiratory dysfunction. Among surgical and trauma patients, aggressive fluid resuscitation is the most commonly reported risk factor to develop ACS. Other conditions that have also been identified as risk factors are ascites, hemoperitoneum, bowel distention, and large tumors. All patients with abdominal trauma possess a higher risk of developing intra-abdominal hypertension (IAH). Certain surgical interventions are reported to have a higher risk to develop IAH such as damage control surgery, abdominal aortic aneurysm repair, and liver transplantation among others. Close monitoring of organ function and intra-abdominal pressure (IAP) allows clinicians to diagnose ACS rapidly and intervene with target-specific management to reduce IAP. Surgical decompression followed by temporary abdominal closure should be considered in all patients with signs of organ dysfunction. There is still a great need for more studies to determine the adequate timing for interventions to improve patient outcomes.

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Abdominal compartment syndrome: Often overlooked conditions in medical intensive care units

Cited by 52 publications

References 44 publications

Phlegmonous gastritis complicated by abdominal compartment syndrome: a case report

Phlegmonous gastritis complicated by abdominal compartment syndrome: a case report

A New Device for Measuring Abdominal Wall Tension and Its Value in Screening Abdominal Infection

Abdominal compartment syndrome among surgical patients

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