Pediatr Emerg Med J.  2021 Dec;8(2):112-115. 10.22470/pemj.2021.00332.

Abdominal compartment syndrome in a 10-year-old boy with delayed presentation of congenital aganglionic megacolon

  • 1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea


Abdominal compartment syndrome (ACS) involves adverse physiologic consequences arising from the increased intra-abdominal pressure, leading to high mortality. However, this syndrome has been scarcely reported in pediatric emergency settings. We describe a 10-year-old boy with ACS presenting with painful abdominal distension, oliguria, and dyspnea. Despite the absence of known congenital anomalies, he had undergone frequent episodes of constipation since 5 years of age, and had not defecated for recent 2 months. With computed tomography scans showing the entire colorectal distension, his manifestations were considered to have stemmed from congenital aganglionic megacolon, which had gone undetected. This case underlines the needs for considering ACS and consequent surgical decompression in a child with severe abdominal distension.


Compartment Syndromes; Decompression, Surgical; Hirschsprung Disease; Intra-Abdominal Hypertension; Lower Body Negative Pressure


  • Fig. 1. Plain radiograph showing the distended bowel loops with fecal impaction.

  • Fig. 2. Computed tomographic scans showing (A) the entire colorectal distension (arrow and arrowhead), (B) posterior displacement of both kidneys (arrows), and (C) the severely compressed inferior vena cava (arrow) with the visible aorta (arrowhead).



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