J Korean Soc Radiol.  2025 Mar;86(2):284-290. 10.3348/jksr.2024.0071.

A Case Report of Contrasting Pre- and Post-Emergency Percutaneous Catheter Drainage CT Images in Patients Having Trauma with Severe Abdominal Compartment Syndrome: A Valuable Tool for Identifying Hemorrhage Sources

• Im JY
• Seo SH

• KMID: 2566610
• DOI: http://doi.org/10.3348/jksr.2024.0071

Abstract

Abdominal compartment syndrome (ACS) is a life-threatening condition that rarely occurs in patients with severe abdominal trauma. Increased intra-abdominal pressure, often owing to hemoperitoneum, can reduce the mesenteric blood flow, making it challenging to evaluate the bleeding focus in multi-detector CT. Herein, we report a case of severe ACS after abdominal trauma. The initial CT scan showed hemoperitoneum but the source of active bleeding could not be identified. Percutaneous catheter drainage (PCD) was promptly performed to reduce the intra-abdominal pressure. Additional CT scans confirmed the bleeding source to be the superior mesenteric vein. The patient presented CT findings of primary ACS, and we evaluated the pre- and post-ACS imaging changes after PCD on abdominal CT. Accurate and timely recognition of the characteristic CT signs of ACS and shock bowel as well as precise interventional treatment are important skills for radiologists, particularly in cases of severe trauma and hypovolemia.

Keyword

Abdominal Compartment Syndrome; Intra-Abdominal Hypertension; Shock Bowel Syndrome; Percutaneous Drainage; Abdominal Trauma