Joshi Bijendra Dhoj, Koirala Udaya, Upadhyaya Amit M, Joshi Arbin, Dhital Saroj
Department of Surgery, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
J Nepal Health Res Counc. 2017 Sep 8;15(2):159-163. doi: 10.3126/jnhrc.v15i2.18206.
The gold standard of quick and definitive treatment of Abdominal compartment syndrome (ACS) is surgical decompression by opening the abdomen and leaving it open until intra-abdominal pressure decreases. Temporary abdominal closure techniques are used to postpone definite closure until predisposing factors causing pathologic elevation of intra-abdominal pressure are resolved.This study aim to analyze feasibility of Bogota Bag placement as a way of temporary abdominal closure.
Cases admitted in the period of eight years that were diagnosed to have or at risk to develop ACS and managed with 'Bogota Bag', irrespective of primary diagnosis were reviewed retrospectively. Cause of ACS, reasons to place Bogota bag, its complications and final outcome in terms of mortality related or not related with Bogota Bag placement were assessed.
Total of ten patients had placement of Bogota Bag in the period of eight years. Laparotomy for bowel perforation with peritonitis was the most common primary condition contributing to ACS. Bogota bag was placed in two cases after emergency decompression as a therapeutic measure whereas others were done as prophylactic measure. There were two mortalities (20%) which were not directly related to abdominal compartment syndrome.
Abdomen closure with Bogota Bag for patients with ACS or likely to develop ACS is a feasible technique with minimal procedure related morbidities.
腹内压综合征（ACS）快速明确治疗的金标准是通过开腹进行手术减压并保持腹腔开放，直至腹内压降低。临时腹部闭合技术用于推迟确定性闭合，直到导致腹内压病理性升高的诱发因素得到解决。本研究旨在分析放置波哥大包作为临时腹部闭合方法的可行性。
回顾性分析8年间收治的诊断为患有或有发展为ACS风险且采用“波哥大包”治疗的病例，无论其初步诊断如何。评估ACS的病因、放置波哥大包的原因、其并发症以及与放置波哥大包相关或不相关的死亡率方面的最终结局。
8年间共有10例患者放置了波哥大包。因肠穿孔伴腹膜炎行剖腹手术是导致ACS最常见的主要情况。2例在紧急减压后放置波哥大包作为治疗措施，其他则作为预防措施。有2例死亡（20%），与腹内压综合征无直接关系。
对于患有ACS或可能发展为ACS的患者，用波哥大包闭合腹部是一种可行的技术，与手术相关的发病率极低。
