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骨盆骨折稳定患者因大量静脉出血导致腹腔间隔室综合征所致脑死亡:病例报告

Brain death due to abdominal compartment syndrome caused by massive venous bleeding in a patient with a stable pelvic fracture: report of a case.

作者信息

Hagiwara Akiyoshi, Fukushima Hideki, Inoue Tetsuya, Murata Atsuo, Shimazaki Shuji

机构信息

Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.

出版信息

Surg Today. 2004;34(1):82-5. doi: 10.1007/s00595-003-2638-8.

Abstract

We report a rare case in which abdominal compartment syndrome resulting from venous hemorrhaging developed in a patient with stable pelvic fractures, resulting in a fatal outcome. An 84-year-old man with mild pelvic fractures developed hypovolemic shock and underwent transcatheter arterial embolization. He became hemodynamically stable after the procedure, but became hypotensive for the second time 11 h after admission. Urinary bladder pressure rose to 32 mmHg from 4-7 mmHg. Rebleeding from the pelvis with the development of abdominal compartment syndrome was suspected. Repeated transcatheter arterial embolization and laparotomy were performed; however, 1 min into the procedure, both pupils symmetrically dilated and the light reflex disappeared. This case suggests that brain death can sometimes occur due to abdominal compartment syndrome.

摘要

我们报告了一例罕见病例,一名骨盆骨折稳定的患者因静脉出血导致腹腔间隔室综合征,最终死亡。一名84岁男性,骨盆轻度骨折,发生低血容量性休克并接受了经导管动脉栓塞术。术后血流动力学稳定,但入院11小时后再次出现低血压。膀胱压力从4 - 7 mmHg升至32 mmHg。怀疑骨盆再次出血并伴有腹腔间隔室综合征。进行了重复经导管动脉栓塞术和剖腹手术;然而,手术开始1分钟后,双侧瞳孔对称散大,光反射消失。该病例提示腹腔间隔室综合征有时可导致脑死亡。

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