Life-threatening abdominal compartment syndrome as a complication of supine super mini percutaneous nephrolithotomy, the first case report and literature review

Abstract

Abdominal compartment syndrome is a life-threatening complication of conventional percutaneous nephrolithotomy (PCNL), with few cases reported in different positions. We present the first case of abdominal compartment syndrome as a complication of supermini percutaneous nephrolithotomy (SMP) in The Galdakao-modified supine Valdivia position, possibly predisposing factors, diagnosis, and management. Although it is a challenging diagnosis and life-threatening condition, morbidity and mortality can be decreased with early detection and drainage of the intra-peritoneal fluid, causing increased abdominal pressure, which is the most important prognostic factor.

Abdominal compartment syndrome after endoscopic combined intrarenal surgery

“…Khalil et al reported that risk factors for hydroperitoneum include an increased amount of irrigation fluid, operative time of more than 60-90 min, renal pelvis mucosal tear, and peritoneal scarring caused by previous ECIRS or PNL. 8 In this case, a minor peritoneal injury could have been overlooked. However, fluid overload should not be ruled out.…”

“… 1 It is a rare complication as, to our knowledge, only nine cases have been previously reported (Table 1 ). 2 , 3 , 4 , 5 , 6 , 7 , 8 …”

“…According to previous reports, increased airway pressure, distended abdomen, or tachycardia, was an early sign of hydroperitoneum. 2 , 3 , 4 , 5 , 6 , 7 , 8 However, these signs may suggest a condition that led to ACS.…”

“…Percutaneous drainage was conducted for treatment in all previously reported cases. 2 , 3 , 4 , 5 , 6 , 7 , 8 It can be performed quickly, but its safety is questionable unless the fluid collection is visible on ultrasonography. Laparotomy is superior in terms of efficient drainage and surgical repair of abdominal organ injury.…”

“…1 It is a rare complication as, to our knowledge, only nine cases have been previously reported (Table 1). [2][3][4][5][6][7][8] Two mechanisms may result in hydroperitoneum. First, mucosal tearing may cause intravascular absorption of irrigation fluid.…”