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Title: Severe pancreatitis complicated by abdominal compartment syndrome managed with decompressive laparotomy: a case report.
Austin Authors: Lee, Adele Hwee Hong;Lee, Wen-Shen;Anderson, David
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Department of Intensive Care, The Alfred Hospital, Melbourne, Victoria, 3004, Australia
The Alfred Hospital, Melbourne, Victoria, 3004, Australia
Issue Date: 17-Aug-2019
Date: 2019-08-17
Publication information: BMC surgery 2019; 19(1): 113
Abstract: 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. 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. 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.
DOI: 10.1186/s12893-019-0575-8
ORCID: 0000-0003-3653-682X
Journal: BMC surgery
PubMed URL: 31419970
Type: Journal Article
Subjects: Case reports
Decompression, surgical
Intra-abdominal hypertension
Multiple organ failure
Appears in Collections:Journal articles

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