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Abdominal Compartment Syndrome (abdominal + compartment_syndrome)
Selected AbstractsABDOMINAL COMPARTMENT SYNDROME AFTER RUPTURED ABDOMINAL AORTIC ANEURYSMANZ JOURNAL OF SURGERY, Issue 8 2008John Y. S. Choi Abdominal Compartment Syndrome (ACS) is an increasingly recognized syndrome of intra-abdominal hypertension and generalized physiological dysfunction in critically ill patients. Patients suffering a ruptured abdominal aortic aneurysm (rAAA) are at risk of developing ACS. The objective of the study was to compare the current views on the importance, prevalence and management of ACS after rAAA among Australian vascular surgeons and intensivists. A questionnaire was mailed to 116 registered vascular fellows from the Royal Australasian College of Surgeons and 314 registered fellows of the Joint Faculty of Intensive Care Medicine. Data were collected on the prevalence and importance of ACS after rAAA and whether prophylactic measures were or should be taken to prevent ACS. Hypothetical clinical scenarios representing a range of ACS after rAAA were also presented. The responses were compared using ,2 -test and t -test. Sixty-seven per cent (78 of 116) of surgeons and 39% (122 of 314) of intensivists responded. Both groups estimated the prevalence of ACS after rAAA as between 10 and 30% and considered it an important entity. Only 30% of surgeons and 50% of intensivists suggested routine intra-abdominal pressure (IAP) monitoring. In patients with borderline IAP (18 mmHg), both groups believed that surgical intervention was unnecessary. Intensivists were more inclined to suggest surgical intervention for clinically deteriorating patients with an increased IAP (30 mmHg) compared with surgeons. Forty-three per cent of intensivists and 17% of surgeons suggested prophylactic (leaving the abdomen open) measures to prevent ACS in high-risk patients. Surgeons and intensivists have similar views on the prevalence and clinical importance of ACS after rAAA. Intensivists more frequently monitored IAP and suggested both early prophylactic and therapeutic intervention for ACS based on physiological and IAP findings. [source] Case Report of Cardiac Arrest, Abdominal Compartment Syndrome, and Thoracic Aortic Injury with Endovascular Repair of Thoracic Aortic TearJOURNAL OF CARDIAC SURGERY, Issue 4 2007Randy M. Stevens M.D. Currently, endografts are not FDA-approved for treating thoracic aortic injury (TAI). We report a case of TAI who presented in hemorrhagic shock and preoperative cardiac arrest who was successfully treated with large volume resuscitation, closed chest cardiac massage, exploratory laparotomy, and thoracic endografting. [source] ABDOMINAL COMPARTMENT SYNDROME AFTER RUPTURED ABDOMINAL AORTIC ANEURYSMANZ JOURNAL OF SURGERY, Issue 8 2008John Y. S. Choi Abdominal Compartment Syndrome (ACS) is an increasingly recognized syndrome of intra-abdominal hypertension and generalized physiological dysfunction in critically ill patients. Patients suffering a ruptured abdominal aortic aneurysm (rAAA) are at risk of developing ACS. The objective of the study was to compare the current views on the importance, prevalence and management of ACS after rAAA among Australian vascular surgeons and intensivists. A questionnaire was mailed to 116 registered vascular fellows from the Royal Australasian College of Surgeons and 314 registered fellows of the Joint Faculty of Intensive Care Medicine. Data were collected on the prevalence and importance of ACS after rAAA and whether prophylactic measures were or should be taken to prevent ACS. Hypothetical clinical scenarios representing a range of ACS after rAAA were also presented. The responses were compared using ,2 -test and t -test. Sixty-seven per cent (78 of 116) of surgeons and 39% (122 of 314) of intensivists responded. Both groups estimated the prevalence of ACS after rAAA as between 10 and 30% and considered it an important entity. Only 30% of surgeons and 50% of intensivists suggested routine intra-abdominal pressure (IAP) monitoring. In patients with borderline IAP (18 mmHg), both groups believed that surgical intervention was unnecessary. Intensivists were more inclined to suggest surgical intervention for clinically deteriorating patients with an increased IAP (30 mmHg) compared with surgeons. Forty-three per cent of intensivists and 17% of surgeons suggested prophylactic (leaving the abdomen open) measures to prevent ACS in high-risk patients. Surgeons and intensivists have similar views on the prevalence and clinical importance of ACS after rAAA. Intensivists more frequently monitored IAP and suggested both early prophylactic and therapeutic intervention for ACS based on physiological and IAP findings. [source] Abdominal compartment syndrome: a new indication for operative intervention in severe acute pancreatitisINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 12 2005K. Wong Summary The current management of severe acute pancreatitis (SAP) is maximal conservative therapy within an intensive care environment. The only commonly accepted indication for operative intervention is the presence of infected pancreatic necrosis. We present a case wherein a laparotomy performed for treatment of abdominal compartment syndrome (ACS) arising in the setting of SAP in the absence of pancreatic necrosis prevented early mortality and discuss the diagnosis and treatment of ACS as a new indication for operative intervention in SAP. [source] Abdominal compartment syndrome after liver transplantationLIVER TRANSPLANTATION, Issue 1 2005Alexander E. Handschin The abdominal compartment syndrome is a well-known complication after abdominal trauma and is increasingly recognized as a potential risk factor for renal failure and mortality after adult orthotopic liver transplantation (OLT). We present a case report of a young patient who presented with acute liver failure complicated by an acute pancreatitis. The patient developed an acute abdominal compartment syndrome after OLT. Transurethral measurement of intraabdominal pressure indicated an abdominal compartment syndrome associated with impaired abdominal vascular perfusion, including liver perfusion. Renal insufficiency was immediately reversed after decompressive bedside laparotomy. The abdominal compartment syndrome is a potential source of posttransplant renal insufficiency and liver necrosis in OLT. It remains, however, a rarely described complication after liver transplantation, despite the presence of significant factors that contribute to elevated intraabdominal pressure. (Liver Transpl 2005;11:98,100.) [source] Abdominal compartment syndrome during hip arthroscopyANAESTHESIA, Issue 5 2009A. Sharma Summary Hip arthroscopy is recognised as a highly effective means of treating joint disorders. The majority of complications associated with hip arthroscopy involve neurovascular traction injury. We report a relatively unusual complication of hip arthroscopy, extravasation of irrigation fluid into the retroperitoneal and intraperitoneal cavities, resulting in abdominal compartment syndrome. [source] Prospective study of the incidence and outcome of intra-abdominal hypertension and the abdominal compartment syndromeBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2002Dr J. J. Hong Background: Intra-abdominal hypertension has been recognized as a source of morbidity and mortality in the traumatized patient following laparotomy. Multiple organ dysfunction attributable to intra-abdominal hypertension has been called the abdominal compartment syndrome. The epidemiology and characteristics of these processes remain poorly defined. Methods: Intra-abdominal pressure was measured prospectively in all patients admitted to a trauma intensive care unit over 9 months. Data were gathered on all patients with intra-abdominal hypertension. Results: Some 706 patients were evaluated. Fifteen (2 per cent) of 706 patients had intra-abdominal hypertension. Six of the 15 patients with intra-abdominal hypertension had abdominal compartment syndrome. Half of the patients with abdominal compartment syndrome died, as did two of the remaining nine patients with intra-abdominal hypertension. Patients with abdominal compartment syndrome had a mean intra-abdominal pressure of 42 mmHg compared with 26 mmHg in patients with intra-abdominal hypertension only (P < 0·05). Conclusion: The incidence of intra-abdominal hypertension and abdominal compartment syndrome was 2 and 1 per cent respectively. Intra-abdominal hypertension did not necessarily lead to abdominal compartment syndrome, and often resolved without clinical sequelae. Abdominal compartment syndrome did not occur in the absence of earlier laparotomy. Abdominal compartment syndrome was associated with a marked increase in intra-abdominal pressure (above 40 mmHg). © 2002 British Journal of Surgery Society Ltd [source] Abdominal compartment syndrome: a new indication for operative intervention in severe acute pancreatitisINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 12 2005K. Wong Summary The current management of severe acute pancreatitis (SAP) is maximal conservative therapy within an intensive care environment. The only commonly accepted indication for operative intervention is the presence of infected pancreatic necrosis. We present a case wherein a laparotomy performed for treatment of abdominal compartment syndrome (ACS) arising in the setting of SAP in the absence of pancreatic necrosis prevented early mortality and discuss the diagnosis and treatment of ACS as a new indication for operative intervention in SAP. [source] Review article: the abdominal compartment syndromeALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2008S. M. LERNER Summary Background, The term abdominal compartment syndrome refers to hypoperfusion and ischaemia of intra-abdominal viscera and structures caused by raised intra-abdominal pressure. It occurs most commonly following major trauma and complex surgical procedures, but can also occur in their absence. Definitive treatment is decompression at laparotomy. Prevention and recognition of abdominal compartment syndrome are crucial to avoid additional morbidity and mortality. Postinjury abdominal compartment syndrome continues to complicate current resuscitation methods and new strategies for resuscitating critically ill patients need to be explored in addition to more accurate monitoring of intra-abdominal pressure. Aim, To examine the published literature regarding the pathogenesis, diagnosis and management of the abdominal compartment syndrome. Methods, A comprehensive review of the literature was undertaken. Results, This syndrome is an important complication of major trauma and surgery as well as being recognized in critically-ill medical patients. It requires prompt recognition with a view to decompression at laparotomy. Conclusions, The abdominal compartment syndrome is an important complication of trauma, surgery and resuscitation. Key to its management are its prompt recognition and abdominal decompression. [source] Abdominal compartment syndrome after liver transplantationLIVER TRANSPLANTATION, Issue 1 2005Alexander E. Handschin The abdominal compartment syndrome is a well-known complication after abdominal trauma and is increasingly recognized as a potential risk factor for renal failure and mortality after adult orthotopic liver transplantation (OLT). We present a case report of a young patient who presented with acute liver failure complicated by an acute pancreatitis. The patient developed an acute abdominal compartment syndrome after OLT. Transurethral measurement of intraabdominal pressure indicated an abdominal compartment syndrome associated with impaired abdominal vascular perfusion, including liver perfusion. Renal insufficiency was immediately reversed after decompressive bedside laparotomy. The abdominal compartment syndrome is a potential source of posttransplant renal insufficiency and liver necrosis in OLT. It remains, however, a rarely described complication after liver transplantation, despite the presence of significant factors that contribute to elevated intraabdominal pressure. (Liver Transpl 2005;11:98,100.) [source] Life threatening tension pneumoperitoneum from intestinal perforation during air reduction of intussusceptionPEDIATRIC ANESTHESIA, Issue 9 2002E. Ng MD, FRCPC Summary We present a case report of a child with intussusception who underwent air reduction which was complicated by bowel perforation. Life threatening tension pneumoperitoneum developed rapidly and immediate needle decompression was life saving in this case. The pathophysiology of hyperacute abdominal compartment syndrome is discussed. [source] Abdominal compartment syndrome during hip arthroscopyANAESTHESIA, Issue 5 2009A. Sharma Summary Hip arthroscopy is recognised as a highly effective means of treating joint disorders. The majority of complications associated with hip arthroscopy involve neurovascular traction injury. We report a relatively unusual complication of hip arthroscopy, extravasation of irrigation fluid into the retroperitoneal and intraperitoneal cavities, resulting in abdominal compartment syndrome. [source] DETERMINING NORMAL VALUES FOR INTRA-ABDOMINAL PRESSUREANZ JOURNAL OF SURGERY, Issue 12 2006Joanne J. L. Chionh Background: Intra-abdominal pressure (IAP) measurements can be used for the early detection and management of the abdominal compartment syndrome. IAP values are widely thought to be atmospheric or subatmospheric. However, there are no reports that describe normal IAP values using urinary bladder pressure measurements in patients not suspected of having a raised IAP level. This study sought to determine these normal values to aid our interpretation of IAP measurements in post-surgical patients or patients with suspected increased IAP. Methods: Urinary bladder pressure measurements were carried out in 40 men and 18 women awake medical or non-abdominal surgery inpatients with existing indwelling catheters. Measurements were made in the supine, 30° and 45° sitting positions. Comparisons were carried out to determine the effects on urinary bladder pressure of body position, sex and a suspected diagnosis of benign prostatic hypertrophy. Results: Median values for IAP were higher if measured in a more upright position (P < 0.0001). Median values were supine, 9.5 cmH2O (range, 1,18 cmH2O); 30° upright, 11.5 cmH2O (range, 3,19 cmH2O); and at 45° upright, 14.0 cmH2O (range, 4,22 cmH2O). Measurements recorded were neither atmospheric nor subatmospheric. IAP was higher in men compared with women in the supine and 30° positions (P < 0.05) but not in the 45° position (P = 0.083). There was no significant difference between patients with and without suspected benign prostatic hypertrophy. Conclusions: Normal IAP using urinary bladder pressure in awake patients are above atmospheric pressure. As a patient is moved from the supine into the upright position, IAP measurements increase. [source] Prospective study of the incidence and outcome of intra-abdominal hypertension and the abdominal compartment syndromeBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2002Dr J. J. Hong Background: Intra-abdominal hypertension has been recognized as a source of morbidity and mortality in the traumatized patient following laparotomy. Multiple organ dysfunction attributable to intra-abdominal hypertension has been called the abdominal compartment syndrome. The epidemiology and characteristics of these processes remain poorly defined. Methods: Intra-abdominal pressure was measured prospectively in all patients admitted to a trauma intensive care unit over 9 months. Data were gathered on all patients with intra-abdominal hypertension. Results: Some 706 patients were evaluated. Fifteen (2 per cent) of 706 patients had intra-abdominal hypertension. Six of the 15 patients with intra-abdominal hypertension had abdominal compartment syndrome. Half of the patients with abdominal compartment syndrome died, as did two of the remaining nine patients with intra-abdominal hypertension. Patients with abdominal compartment syndrome had a mean intra-abdominal pressure of 42 mmHg compared with 26 mmHg in patients with intra-abdominal hypertension only (P < 0·05). Conclusion: The incidence of intra-abdominal hypertension and abdominal compartment syndrome was 2 and 1 per cent respectively. Intra-abdominal hypertension did not necessarily lead to abdominal compartment syndrome, and often resolved without clinical sequelae. Abdominal compartment syndrome did not occur in the absence of earlier laparotomy. Abdominal compartment syndrome was associated with a marked increase in intra-abdominal pressure (above 40 mmHg). © 2002 British Journal of Surgery Society Ltd [source] | ||||||||||||||||||||||