Hagiwara Akiyoshi, Fukushima Hideki, Inoue Tetsuya, Murata Atsuo, Shimazaki Shuji
Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
Surg Today. 2004;34(1):82-5. doi: 10.1007/s00595-003-2638-8.
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.
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。
