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张力性气腹:一种罕见的急性腹腔间隔室综合征形式的病例报告。

Tension pneumoperitoneum: Case report of a rare form of acute abdominal compartment syndrome.

作者信息

Cadena Manuel, Solano Jaime, Caycedo Nicolas, Gomez Daniel, Vinck Eric E, Quiroga Pedro, Gaete Paula

机构信息

Department of Surgery, Fundación Santa Fé de Bogotá, Bogotá, Colombia; Universidad de Los Andes, Colombia.

Department of Surgery, Universidad El Bosque, Bogotá, Colombia.

出版信息

Int J Surg Case Rep. 2019;55:112-116. doi: 10.1016/j.ijscr.2019.01.014. Epub 2019 Jan 29.

Abstract

INTRODUCTION

Tension pneumoperitoneum is a severe and rare form of pneumoperitoneum with concomitant hemodynamic instability and respiratory failure. It is a variant of abdominal compartment syndrome (ACS) causing an abrupt increase in intra-abdominal pressure.

PRESENTATION OF CASE

We present a case of pneumoperitoneum, after an endoscopic mucosal resection with the development of ACS. The patient was successfully treated with percutaneous decompression.

DISCUSSION

Decompressive laparotomy is the first treatment option for both most forms of pneumoperitoneum and ACS; nevertheless, this issue is controversial. Recent reports have shown that some patients may be candidates for a minimally invasive catheter decompression avoiding major decompressive surgery. Identifying these patients is vital to avoiding unnecessary surgeries.

CONCLUSIONS

Tension pneumoperitoneum is a life-threatening event, early detection and intervention is critical in order to provide prompt and optimal treatment approaches.

摘要

引言

张力性气腹是气腹的一种严重且罕见的形式,伴有血流动力学不稳定和呼吸衰竭。它是腹腔间隔室综合征(ACS)的一种变体,可导致腹内压突然升高。

病例介绍

我们报告一例在内镜黏膜切除术后发生气腹并发展为ACS的病例。该患者通过经皮减压成功治疗。

讨论

剖腹减压术是大多数气腹和气腹间隔室综合征的首选治疗方法;然而,这个问题存在争议。最近的报告表明,一些患者可能适合微创导管减压,从而避免进行大型减压手术。识别这些患者对于避免不必要的手术至关重要。

结论

张力性气腹是一种危及生命的情况,早期检测和干预对于提供及时和最佳的治疗方法至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c23c/6360270/f15f46c681ce/gr1.jpg

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