Decompressive laparotomy for abdominal compartment syndrome resulting from severe acute pancreatitis: a case report

BMC Gastroenterology
Shinya IkedaKen Sugimoto

Abstract

Abdominal compartment syndrome (ACS) is associated with mortality in patients with critical illness such as severe acute pancreatitis, but it remains unclear whether decompressive laparotomy for ACS can improve the prognosis of patients. A woman in her 60s visited our hospital because of upper abdominal pain. On the basis of her laboratory data and abdominal contrast-enhanced computed tomography findings, acute gallstone pancreatitis was diagnosed. She underwent endoscopic sphincterotomy for the removal of the common bile duct stone. Then, a drainage tube was placed in the bile duct. However, on the 5th hospital day, her intra-abdominal pressure increased to 22 mmHg and renal dysfunction was observed, which led to the diagnosis of ACS. As intensive medical treatments did not improve her ACS, she underwent decompressive laparotomy on the 9th hospital day. Postoperatively, her laboratory data and intravesical pressure improved, and she was discharged from the hospital after abdominal closure, continuous drainage, and antibiotic therapy. As the effectiveness of decompressive laparotomy for ACS has not been established, this treatment indication remains controversial. Decompressive laparotomy is considered useful for the management...Continue Reading

References

Feb 6, 2004·Intensive Care Medicine·Manu L N G MalbrainLuciano Gattinoni
Mar 16, 2004·Journal of Huazhong University of Science and Technology. Medical Sciences = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying De Wen Ban = Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban·Jing TaoFeng Zhou
Jun 21, 2008·World Journal of Gastroenterology : WJG·Hong ChenJian-Guo Jia
Apr 8, 2009·World Journal of Surgery·Jan J De Waele, Ari K Leppäniemi
Jun 3, 2009·Critical Care Medicine·Michael L CheathamUNKNOWN World Society of the Abdominal Compartment Syndrome (WSACS) Clinical Trials Working Group
Aug 18, 2010·Archives of Surgery·Panu MentulaAri Leppäniemi
May 16, 2013·Intensive Care Medicine·Andrew W KirkpatrickUNKNOWN Pediatric Guidelines Sub-Committee for the World Society of the Abdominal Compartment Syndrome
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Jun 4, 2014·ANZ Journal of Surgery·Abraham O JacobOllapallil Jacob
Jun 13, 2014·Pancreas·Sandra van BrunschotUNKNOWN Dutch Pancreatitis Study Group

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