Handschin Alexander E, Weber Markus, Renner Eberhard, Clavien Pierre-Alain
Department of Visceral and Transplant Surgery, University Hospital Zurich, Ramistr. 100, 8091 Zurich, Switzerland.
Liver Transpl. 2005 Jan;11(1):98-100. doi: 10.1002/lt.20295.
The abdominal compartment syndrome is a well-known complication after abdominal trauma and is increasingly recognized as a potential risk factor for renal failure and mortality after adult orthotopic liver transplantation (OLT). We present a case report of a young patient who presented with acute liver failure complicated by an acute pancreatitis. The patient developed an acute abdominal compartment syndrome after OLT. Transurethral measurement of intraabdominal pressure indicated an abdominal compartment syndrome associated with impaired abdominal vascular perfusion, including liver perfusion. Renal insufficiency was immediately reversed after decompressive bedside laparotomy. The abdominal compartment syndrome is a potential source of posttransplant renal insufficiency and liver necrosis in OLT. It remains, however, a rarely described complication after liver transplantation, despite the presence of significant factors that contribute to elevated intraabdominal pressure.
腹腔间隔室综合征是腹部创伤后一种众所周知的并发症,并且越来越被认为是成人原位肝移植(OLT)后肾衰竭和死亡的潜在危险因素。我们报告一例年轻患者,其出现急性肝衰竭并伴有急性胰腺炎。该患者在OLT后发生了急性腹腔间隔室综合征。经尿道测量腹内压显示存在与腹部血管灌注受损(包括肝脏灌注)相关的腹腔间隔室综合征。床边减压剖腹术后肾功能不全立即得到逆转。腹腔间隔室综合征是OLT后移植肾功能不全和肝坏死的潜在原因。然而,尽管存在导致腹内压升高的重要因素,但它仍然是肝移植后一种很少被描述的并发症。