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abdominal compartment syndrome:Often overlooked conditions in medical intensive care units

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World Journal of Gastroenterology 2020年第3期26卷 266-278页

作者： Venkat Rajasurya Salim Surani Department of Pulmonary and Critical Care Novant Health SystemWinston-SalemNC 27103United States Department of Pulmonary Critical Care and Sleep Medicine Texas A&M Health Science CenterBryanTX 77807United States

Intra-abdominal hypertension(IAH)and abdominal compartment syndrome are well recognized entities among surgical ***,a number of prospective and retrospective observational studies have shown that IAH is prevalent in about half of the critically ill patients in the medical intensive care units(ICU)and has been widely recognized as an independent risk factor for *** is alarming to note that many members of the critical care team in medical ICU are not aware of the consequences of untreated IAH and the delay in making the diagnosis leads to increased morbidity and *** it is underdiagnosed and undertreated in this patient *** intraabdominal pressure decreases the blood flow to the kidneys and other abdominal viscera and also results in reduced cardiac output and difficulties in ventilating the patient because of increased intrathoracic *** intraabdominal hypertension is not promptly recognized and treated,it leads to abdominal compartment syndrome,multiorgan dysfunction syndrome and *** volume fluid resuscitation is very common in medical ICU patients presenting with sepsis,shock and other inflammatory conditions like pancreatitis and it is one of the major risk factors for the development of intra-abdominal *** article presents an overview of the epidemiology,definitions,risk factors,pathophysiology and management of IAH and abdominal compartment syndrome in critically ill medical ICU patients.

关键词： Intra-abdominal pressure Intra-abdominal hypertension abdominal compartment syndrome Acute kidney injury Large volume resuscitation Open abdomen Bladder pressure Medical intensive care unit

abdominal compartment syndrome among surgical patients

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World Journal of Gastrointestinal Surgery 2021年第4期13卷 330-339页

作者： Monica Leon Luis Chavez Salim Surani Department of Medicine Centro Medico ABCCiudad de Mexico 01120Mexico Department of Medicine University of TexasEl PasoTX 79905United States Department of Medicine Texas A&M UniversityCorpus ChristiTX 78405United States

abdominal compartment syndrome(ACS)develops when organ failure arises secondary to an increase in intraabdominal *** abdominal pressure is determined by multiple factors such as blood pressure,abdominal compliance,and other factors that exert a constant pressure within the abdominal *** conditions in the critically ill may increase abdominal pressure compromising organ perfusion that may lead to renal and respiratory *** surgical and trauma patients,aggressive fluid resuscitation is the most commonly reported risk factor to develop *** conditions that have also been identified as risk factors are ascites,hemoperitoneum,bowel distention,and large *** patients with abdominal trauma possess a higher risk of developing intra-abdominal hypertension(IAH).Certain surgical interventions are reported to have a higher risk to develop IAH such as damage control surgery,abdominal aortic aneurysm repair,and liver transplantation among *** monitoring of organ function and intra-abdominal pressure(IAP)allows clinicians to diagnose ACS rapidly and intervene with target-specific management to reduce *** decompression followed by temporary abdominal closure should be considered in all patients with signs of organ *** is still a great need for more studies to determine the adequate timing for interventions to improve patient outcomes.

关键词： Intra-abdominal hypertension abdominal compartment syndrome Intraabdominal pressure Open abdomen treatment Multiple organ failure Surgical decompression

Hemorrhoid sclerotherapy with the complication of abdominal compartment syndrome： report of a case

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Chinese Medical Journal 2011年第12期124卷 1919-1920页

作者： YANG Peng WANG Ya-jun LI Fei SUN Jia-bang Department of General Surgery Xuan Wu Hospital CapitalMedical University Beijing 100053 China

The complications of injection sclerotherapy for hemorrhoid are always local. Herein, we report a case in which a female patient with abdominal compartment syndrome developed after receiving a local injection of a scl... 详细信息

关键词： hemorrhoid sclerotherapy complication abdominal compartment syndrome

Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis

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World Journal of Gastroenterology 2006年第31期12卷 5068-5070页

作者： Zhao-Xi Sun Hai-Rong Huang Hong Zhou Department of General Surgery Affiliated Hospital of Hainan Medical College Haikou 570102 Hainan Province China Epidemiology Section Department of Preventive Medicine Hainan Medical College Haikou 571101 Hainan Province China

AIM： To study the effect of combined indwelling catheter, hemofiltration, respiration support and traditional Chinese medicine （e.g. Dahuang） in treating abdominal compartment syndrome of fulminant acute pancreatitis. METHODS： Patients with fulminant acute pancreatitis were divided randomly into 2 groups of combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring and routine conservative measures group （group 1） and control group （group 2）. Routine non-operative conservative treatments including hemofiltration, respiration support, gastrointestinal TCM ablution were also applied in control group patients. Effectiveness of the two groups was observed, and APACHE Ⅱ scores were applied for analysis. RESULTS： On the second and fifth days after treatment, APACHE Ⅱ scores of group 1 and 2 patients were significantly different. Comparison of effectiveness （abdominalgia and burbulence relief time, hospitalization time） between groups 1 and 2 showed significant difference, as well as incidence rates of cysts formation. Mortality rates of groups 1 and 2 were 10.0% and 20.7%, respectively. For patients in group 1, celiac drainage quantity and intra-abdominal pressure, and hospitalization time were positively correlated （r = 0.552, 0.748, 0.923, P 〈 0.01） with APACHE Ⅱ scores. CONCLUSION： Combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring, short veno-venous hemofiltration （SVVH）, gastrointestinal TCM ablution, respiration support have preventive and treatment effects on abdominal compartment syndrome of fulminant acute pancreatitis.

关键词： Fulminant acute pancreatitis abdominal compartment syndrome Indwelling catheter Disposable central venous catherization Celiac drainage Intra- abdominal pressure monitoring Combined treatment

Early recognition of abdominal compartment syndrome in patients with acute pancreatitis

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World Journal of Gastroenterology 2009年第6期15卷 717-721页

作者： Zilvinas Dambrauskas Audrius Parseliunas Antanas Gulbinas Juozas Pundzius Giedrius Barauskas Laboratory for Research of Digestive System Institute for Biomedical Research and Department of SurgeryKaunas University of MedicineEiveniu Str.250009 KaunasLithuania Department of Surgery Kaunas University of MedicineEiveniu Str.250009 KaunasLithuania

AIM： To assess the value of widely used clinical scores in the early identification of acute pancreatitis （AP） patients who are likely to suffer from intra-abdominal hypertension （IAH） and abdominal compartment syndrome （ACS）.METHODS： Patients （η = 44） with AP recruited in this study were divided into two groups （ACS and non-ACS） according to intra-abdominal pressure （IAP） determined by indirect measurement using the transvesical route via Foley bladder catheter. On admission and at regular intervals, the severity of the AP and presence of organ dysfunction were assessed utilizing different multifactorial prognostic systems： Glasgow-Imrie score, Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE-Ⅱ） score, and Multiorgan Dysfunction Score （MODS）. The diagnostic performance of scores predicting ACS development, cut-off values and specificity and sensitivity were established using receiver operating characteristic （ROC） curve analysis.RESULTS： The incidence of ACS in our study population was 19.35%. IAP at admission in the ACS group was 22.0 （18.5-25.0） mmHg and 9.25 （3.0-12.4） mmHg in the non-ACS group （P 〈 0.01）. Univariate statistical analysis revealed that patients in the ACS group had significantly higher multifactorial clinical scores （APACHE Ⅱ, Glasgow-Imrie and MODS） on admission and higher maximal scores during hospitalization （P 〈 0.01）. ROC curve analysis revealed that APACHE Ⅱ, Glasgow-Imrie, and MODS are valuable tools for early prediction of ACS with high sensitivity and specificity, and that cut-off values are similar to those used for stratification of patients with severe acute pancreatitis （SAP）.CONCLUSION： IAH and ACS are rare findings in patients with mild AR Based on the results of our study we recommend measuring the IAP in cases when patients present with SAP （APACHE Ⅱ 〉 7; MODS 〉 2 or Glasgow-Imrie score 〉 3）.

关键词： Acute pancreatitis abdominal compartment syndrome Intra-abdominal pressure Intra-abdominal hypertension Organ dysfunction

Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine

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World Journal of Gastroenterology 2008年第22期14卷 3574-3578页

作者： Min-Jie Zhang Guo-Lei Zhang Wen-Bin Yuan Jun Ni Li-Feng Huang Department of General surgery Affiliated Central Hospital of Huzhou Normal College Huzhou 313000 Zhejiang Province China Research Center of Biomedicine and Health Hangzhou Normal University Hangzhou 310000 Zhejiang Province China

AIM: To investigate the therapeutic effect of traditional Chinese traditional medicines Da Cheng Qi Decoction (Timely-Purging and Yin-Preserving Decoction) and Glauber's salt combined with conservative measures on abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP) patients. METHODS: Eighty consecutive SAP patients, admitted for routine non-operative conservative treatment, were randomly divided into study group and control group (40 patients in each group). Patients in the study group received Da Cheng Qi Decoction enema for 2 h and external use of Glauber's salt, once a day for 7 d. Patients in the control group received normal saline (NS) enema. Routine non-operative conservative treatments included non-per os nutrition (NPON), gastrointestinal decompression, life support, total parenteral nutrition (TPN), continuous peripancreatic vascular pharmaceutical infusion and drug therapy. Intra-cystic pressure (ICP) of the two groups was measured during treatment. The effectiveness and outcomes of treatment were observed and APACHE Ⅱ scores were applied in analysis. RESULTS: On days 4 and 5 of treatment, the ICP was lower in the study group than in the control group(P abdominalgia, burbulence relief time, ascites quantity, cyst formation rate and hospitalization time were quite different between the two groups (P abdominal pressure (IAP) of SAP patients and have preventive and therapeutic effects on abdominal compartment syndrome of SAP.

关键词： Da Cheng Qi Decoction Glauber's salt traditional Chinese medicine Severe acute pancreatitis abdominal compartment syndrome

Surgical decompression for the management of abdominal compartment syndrome with severe acute pancreatitis: A narrative review

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世界胃肠外科杂志:英文版(电子版) 2023年第9期15卷 1879-1891页

作者： Prashant Nasa Gunjan Chanchalani Deven Juneja Manu LNG Malbrain Department of Critical Care Medicine NMC Specialty HospitalDubai 7832United Arab Emirates Department of Internal Medicine College of Medicine and Health SciencesAl Ain 15551United Arab Emirates Department of Critical Care Medicine K.J.Somaiya Hospital and Research CentreMumbai 400022India Institute of Critical Care Medicine Max Super Specialty HospitalNew Delhi 110017India First Department of Anaesthesiology and Intensive Therapy Medical University of LublinLublin 20-954Poland Executive Administration International Fluid AcademyLovenjoel 3360Belgium Medical Data Management MedamanGeel 2440Belgium

Intra-abdominal hypertension(IAH)and abdominal compartment syndrome(ACS)play a pivotal role in the pathophysiology of severe acute pancreatitis(SAP)and contribute to new-onset and persistent organ *** optimal management of ACS involves a multi-disciplinary approach,from its early recognition to measures aiming at an urgent reduction of intra-abdominal pressure(IAP).A targeted literature search from January 1,2000,to November 30,2022,revealed 20 studies and data was analyzed on the type and country of the study,patient demographics,IAP,type and timing of surgical procedure performed,post-operative wound management,and outcomes of patients with *** was no randomized controlled trial published on the ***-pressive laparotomy is effective in rapidly reducing IAP(standardized mean difference=2.68,95%confidence interval:1.19-1.47,Pabdominal compartment Society on IAH and *** narrative review focuses on the current evidence regarding surgical decompression techniques for managing ACS in patients with ***,there is a lack of high-quality evidence on patient selection,timing,and modality of surgical *** prospective trials are needed to identify triggers and effective and safe surgical decompression methods in SAP patients with ACS.

关键词： Intra-abdominal hypertension Intra-abdominal pressure Decompression laparotomy Midline laparotomy abdominal compartment syndrome Acute pancreatitis

abdominal compartment syndrome resulting from postpartum hematoma of wall:A rare occurrence associated with a seldom,but high risk of mortality

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Abdominal compartment syndrome resulting from postpartum hem...

Embryonic natural orifice transluminal endoscopic surgery in the treatment of severe acute pancreatitis complicated by abdominal compartment syndrome

2015年浙江省外科学学术年会暨国家级肝胆胰疾病诊治进展学习班

作者： Wang Pin Jia Zhong the Chinese Medical Association the Chinese Medical Association Group of Hhernia and Aabdominal Wwall

Objective:To analyze and summarize the clinical features and diagnosis and treatment of postpartum abdominal hemorrhage with abdominal compartment syndrome(ACS),in order to improve its diagnosis and ***:A retrospective analysis of the clinical data of the four cases of postpartum abdominal hemorrhage with ACS treated in our hospital of from 2009 to 2014 in our hospital,through the clinical data and ***:PPostpartum ACS and is characterized by excessive Postpartum bleedingblood loss *** mMainly as included oliguria,abdominal distention,shortness of breath,etc.;progressive decrease in hhemoglobin,and hematocrit progressively decreased,coagulation disorders;,large volumes of ascites on CT computed tomography and B-type ultrasonography,and significant increases in and B-prompted a large number of ascites fluid accumulation or in part;intra-abdominal pressure,increased significantly,4A11 four patients were takingunderwent surgical decompression and hemostasis,including 1 one case of intestinal necrosis caused by ACS,.Two 2 patients were curedfully recovered,while two 1 patients died:one due to acute respiratory distress syndromeARDS,1 and one from patient died due to lupus ***:Postpartum hemorrhage can cause lead to abdominal ACS,which is maternal life-threatening,.Physicians should attach great importance to timely diagnosis of this phenomena and early surgical decompression is the key to successful treatment.

关键词： postnatal abdominal compartment syndrome ACS abdominal hemorrhage

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World Journal of Emergency Medicine 2015年第1期6卷 23-28页

作者： Hui-ming Zhu Shao-qing Guo Xiu-min Liao Li Zhang Li Cai Department of Gastroenterology Affiliated Donghua Hospital of Sun Yat-sen University

BACKGROUND: The study aimed to estimate the value of embryonal natural orifice transluminal endoscopic surgery(ENOTES) in treating severe acute pancreatitis(SAP) complicated with abdominal compartment syndrome(ACS).METHODS: The patients, who were randomized into an ENOTES group and an operative group, underwent ENOTES and laparotomy, respectively. The results and complications of the two groups were ***: Enterocinesia was observed earlier in the ENOTES group than in the operative group. Acute Physiology and Chronic Health Evaluation II(APACHE II) score of patients in the ENOTES group was lower than that of the operative group on the 1st, 3rd and 5th post-operative day(P<0.05). The cure rate was 96.87% in the ENOTES group, which was statistically different from 78.12% in the operative group(P<0.05). There were significant differences in complications and mortality between the two groups(P<0.01).CONCLUSION: Compared with surgical decompression, ENOTES associated with flexible endoscope therapy is an effective and minimal invasive procedure with less complications.

关键词： Embryonal natural orifi ce transluminal endoscopic surgery Flexible endoscope Peritoneal lavage Peritoneal dialysis Severe acute pancreatitis abdominal compartment syndrome