Division of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA.
Arthroscopy. 2010 Jan;26(1):128-30. doi: 10.1016/j.arthro.2009.06.021.
As hip arthroscopy becomes a more common procedure, more complications may occur. We present a case of abdominal compartment syndrome resulting from fluid extravasation in a 42-year-old man who underwent routine hip arthroscopy for femoral acetabular impingement. He had not had previous surgeries to that hip, and arthroscopy was performed in the supine position. After adequate distraction, arthroscopy was performed with an automated pressure- and flow-controlled pump with the pressure maintained between 40 and 60 mm Hg. We performed debridement of a degenerative tear of the anterosuperior labrum, removal of a pincer lesion, and a psoas tenotomy through a capsular window. A distended abdomen was noted on drape removal, and the patient required decompressive laparotomy for abdominal compartment syndrome. Extravasation of arthroscopy fluid is a potentially devastating complication during hip arthroscopy, and there should be careful monitoring by the surgeons, anesthesiologists, and operating room staff.
随着髋关节镜检查成为一种更为常见的手术,可能会出现更多的并发症。我们报告了一例因液体外渗导致的腹腔间隔室综合征的病例,该病例发生在一名 42 岁男性身上,他因股骨髋臼撞击症接受了常规髋关节镜检查。他之前没有进行过该髋关节的手术,并且手术采用仰卧位进行。在充分牵开后,使用自动压力和流量控制泵进行关节镜检查,压力维持在 40 至 60 毫米汞柱之间。我们通过囊袋窗口进行了前上盂唇退行性撕裂的清创、钳夹病变的切除和腰大肌肌腱切断术。在去除覆盖物时发现腹部膨胀,患者需要进行减压剖腹术以治疗腹腔间隔室综合征。关节镜检查液外渗是髋关节镜检查过程中一种潜在的破坏性并发症,外科医生、麻醉师和手术室工作人员应进行仔细监测。