Shida Masaaki, Kitajima Yoshihiko, Tanaka Masayuki, Tsuji Hiroharu
Department of Surgery, NHO Higashisaga Hospital, Harakoga7324, Miyaki-Cho, Miyaki-Gun, Saga 849-0101, Japan; Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga-shi, Saga 849-8501, Japan.
Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga-shi, Saga 849-8501, Japan; Department of Surgery, Takagi Hospital, 141-11 Sakemi, Okawa-shi, Fukuoka 831-0016, Japan.
Int J Surg Case Rep. 2016;26:128-30. doi: 10.1016/j.ijscr.2016.07.043. Epub 2016 Jul 28.
Abdominal compartment syndrome or intra-abdominal hypertension may occur after intra-abdominal events, but their etiology and clinical signs remain unclear. We report a case of abdominal compartment syndrome in an elderly patient without other risk factors.
An 86-year-old man had been admitted to our hospital several times for a dilated sigmoid colon with elongation, and had complained about abdominal pain and abdominal fullness. At every admission we decompressed the sigmoid colon gas by colonoscopy, resulting in early discharge the following day. Recently, the patient developed dementia and experienced reduced activities of daily living that are common with aging. He frequently complained of severe abdominal distension with hypotension, tachycardia and tachypnea, and finally entered hospital twice a week. We decided to perform elective surgery, which showed abdominal compartment syndrome caused by elongated sigmoid colon without volvulus (the first reported case).
Considering the increase in the aging population, we must bear in mind that abdominal compartment syndrome may occur in simple elongated sigmoid colon without other risk factors.
腹腔间隔室综合征或腹腔内高压可能在腹腔内事件后发生,但其病因和临床体征仍不明确。我们报告一例无其他危险因素的老年患者发生腹腔间隔室综合征的病例。
一名86岁男性因乙状结肠扩张延长多次入住我院,曾抱怨腹痛和腹胀。每次入院时,我们通过结肠镜检查对乙状结肠气体进行减压,次日即可提前出院。最近,该患者出现痴呆,日常生活活动能力下降,这在老年人中很常见。他经常抱怨严重腹胀,伴有低血压、心动过速和呼吸急促,最终每周入院两次。我们决定进行择期手术,结果显示为乙状结肠延长但无肠扭转导致的腹腔间隔室综合征(首例报道病例)。
考虑到老年人口的增加,我们必须牢记,腹腔间隔室综合征可能发生在无其他危险因素的单纯乙状结肠延长病例中。