Korean J Crit Care Med.  2016 Feb;31(1):58-62. 10.4266/kjccm.2016.31.1.58.

Secondary Abdominal Compartment Syndrome Recognized in Operating Room in Severely Injured Patients

Affiliations
  • 1Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea. galgunbam2@daum.net

Abstract

For trauma patients with severe shock, massive fluid resuscitation is necessary. However, shock and a large amount of fluid can cause bowel and retroperitoneal edema, which sometimes leads to abdominal compartment syndrome in patients without abdomino-pelvic injury. If other emergent operations except intraabdomen are needed, a distended abdomen is likely to be recognized late, leading to multiple organ dysfunction. Herein, we report two cases of a 23-year-old woman who was in a car accident and a 53-year old man who was pressed on his leg by a pressing machine; severe brain swelling and popliteal vessel injury were diagnosed, respectively. They were both in severe shock and massive fluid resuscitation was required in the emergency department. Distended abdomen was recognized in both the female and male patients immediately after neurosurgical operation and immediately before orthopaedic operation in the operating room, respectively. Decompressive laparotomy revealed massive ascites with retroperitoneal edema.

Keyword

abdominal compartment syndrome; shock; trauma

MeSH Terms

Abdomen
Ascites
Brain Edema
Edema
Emergency Service, Hospital
Female
Humans
Intra-Abdominal Hypertension*
Laparotomy
Leg
Male
Operating Rooms*
Resuscitation
Shock
Young Adult

Figure

  • Fig. 1. Brain computed tomography scan shows severe brain edema (A) and bowel edema without no hemorrhage in abdominal cavity was observed (B).

  • Fig. 2. A time table until recognizing abdominal compartment syndrome in operating room. ED: emergency department, OR: operating room, CPR: cardiopulmonary resuscitation.

  • Fig. 3. Severe shock was caused by popliteal vessel injury (A) and laparotomy shows lots of ascites (B).

  • Fig. 4. A time table until recognizing abdominal compartment syndrome in operating room. ED: emergency department.


Reference

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