We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Transverse laparostomy is feasible and effective in the treatment of abdominal compartment syndrome in severe acute pancreatitis.
- Authors
Leppäniemi, Ari; Mentula, Panu; Hienonen, Piia; Kemppainen, Esko
- Abstract
Background: Only recently has the important role of abdominal compartment syndrome (ACS) been recognized as a contributing factor to the multiple organ failure commonly seen in severe acute pancreatitis (SAP). Decompressive laparostomy for ACS is a life-saving procedure usually performed through a midline incision followed by a negative pressure wound dressing. High risk of intestinal fistulas and frequent inability to close the fascia with ensuing planned ventral hernia has prompted the search for alternative techniques. Subcutaneous fasciotomy may be effective in early and less severe cases of ACS but it is always accompanied with a ventral hernia. Case report: A patient with SAP developed manifest ACS and was treated with bilateral subcostal laparostomy. Immediately after decompression, the intra-abdominal pressure dropped from 23 mmHg to 10 mmHg, and the respiratory, cardiovascular and renal functions improved markedly leading to full recovery. The abdominal incision including the fascia and the skin was closed gradually over 4 relaparotomies, and during the 6 months' follow up there are no signs of ventral hernia or other wound complications. Discussion: Transverse subcostal laparostomy is a promising alternative decompression technique for ACS in SAP. It is feasible, effective and might provide a chance of early fascial closure. Comparative studies are needed to define its role as a decompressive technique for ACS.
- Subjects
ABDOMINAL diseases; MULTIPLE organ failure; LAPAROSTOMY; PANCREATITIS
- Publication
World Journal of Emergency Surgery, 2008, Vol 3, p1
- ISSN
1749-7922
- Publication type
Case Study
- DOI
10.1186/1749-7922-3-6