Abstract:
BACKGROUND:Abdominal compartment syndrome (ACS) is an uncommon complication of severe pancreatitis. It is defined as a sustained intraabdominal pressure (IAP) > 20 mmHg (with or without an abdominal perfusion pressure (APP) < 60 mmHg), associated with new organ dysfunction/failure. ACS confers a poor prognosis and should be promptly diagnosed and managed. However, it is often missed on clinical examination, leading to a delay of diagnosis. CASE PRESENTATION:A 38-year old Sri Lankan man presented with severe alcohol-induced pancreatitis associated with abdominal compartment syndrome. Diagnosis was delayed due to false reassurance from clinical examination. The patient was managed with a decompressive laparotomy, after which he required treatment with continuous renal replacement therapy (CRRT), total parenteral nutrition (TPN) and broad-spectrum antibiotics for a prolonged period of time. Despite significant post-operative multi-organ failure, the patient survived. CONCLUSIONS:Early trans-bladder measurement of IAP is important for severe pancreatitis. Serial measurements of IAP should be implemented early when any known risk factor for ACS is present in a critically ill patient.
journal_name
BMC Surgjournal_title
BMC surgeryauthors
Lee AHH,Lee WS,Anderson Ddoi
10.1186/s12893-019-0575-8subject
Has Abstractpub_date
2019-08-17 00:00:00pages
113issue
1issn
1471-2482pii
10.1186/s12893-019-0575-8journal_volume
19pub_type
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