Background: The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes.
Methods: This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28-day and 1-year all-cause mortality. Changes in intra-abdominal pressure (IAP) and organ function, and laparotomy-related morbidity were secondary endpoints.
Results: Thirty-three patients were included in the study (20 men). Twenty-seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20-32). Median IAP was 23 (21-27) mmHg before decompressive laparotomy, decreasing to 12 (9-15), 13 (8-17), 12 (9-15) and 12 (9-14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non-survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28-day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non-survivors were no different from survivors, except that they tended to be older and on mechanical ventilation.
Conclusion: Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067589 | PMC |
| http://dx.doi.org/10.1002/bjs.10097 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Complications of Post-Roux-en-Y Gastric Bypass: A Case of Excluded Stomach Perforation.
Cureus
December 2024
Trauma and Acute Care Surgery, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Roux-en-Y gastric bypass (RYGB) is a common surgical treatment for morbid obesity, but rare complications involving the excluded gastric remnant can pose significant challenges. A 65-year-old female with a history of RYGB presented with sudden onset of left upper quadrant abdominal pain, bloating, nausea, and loss of appetite. Laboratory tests revealed leukocytosis.
View Article and Find Full Text PDFBackground: In April 2024, our hospital confirmed a rare case of intra-abdominal infection by Kodamaea ohmeri. The patient sought medical attention at our hospital after taking painkillers orally for one month, experiencing recurrent abdominal pain for 17 days and worsening for 7 days. In March 2024, the patient received symptomatic treatment with oral analgesics (diclofenac sodium) for arthritis.
View Article and Find Full Text PDFArticle Synopsis
- Acute pseudo-obstruction of the colon, known as Ogilvie's syndrome, is a rare complication that can occur after surgery, most commonly seen after cesarean sections, with only one previous case linked to vaginal delivery.
- A case report details a 31-year-old woman who experienced severe abdominal pain and bowel perforation a week after giving birth vaginally, necessitating surgical intervention.
- The report highlights the importance of early detection and treatment of this condition to reduce the risk of serious outcomes, including death.
Sequential Fasciotomies for Managing Abdominal Compartment Syndrome: Porcine Experimental Study.
J Surg Res
November 2024
Division of Complex Abdominal Wall Surgery, Department of Surgery, Henares University Hospital, Madrid, Spain; Complex Abdominal Wall Research Group from Francisco de Vitoria University, Madrid, Spain.
Introduction: Abdominal compartment syndrome (ACS) poses a significant clinical challenge, with high morbidity and mortality rates. Conventional treatment via decompressive laparotomy with open abdomen and temporary closure presents significant drawbacks. This experimental study evaluates the efficacy of open minimally invasive sequential fasciotomy in managing simulated ACS in a porcine model.
View Article and Find Full Text PDFOgilvie syndrome with caecal perforation following cesarean section: a rare case report from Jordan.
Ann Med Surg (Lond)
October 2024
Faculty of Medicine, University of Kalamoon, Al-Nabk, Syria.
Article Synopsis
- Ogilvie syndrome is a rare condition marked by acute colonic dilation, first described in 1948, with an incidence of about 100 cases per 100,000 people annually in the US, and major symptoms include abdominal distention and pain.
- A case study of a 32-year-old pregnant woman revealed that after a caesarean section, she developed severe abdominal pain and distension, leading to the discovery of a caecal perforation requiring surgery.
- This condition, although more common in males, can affect women post-childbirth or pelvic surgery, and diagnosis involves imaging to check for bowel obstruction, while treatment options include conservative measures, medication, or colonoscopic decompression.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!