Hijikawa Takeshi, Kitade Hiroaki, Yanagida Hidesuke, Yamada Masanori, Maruyama Shuhei, Saito Fukuki, Nakamori Yasushi, Yoshioka Kazuhiko
Dept. of Surgery, Kansai Medical University.
Gan To Kagaku Ryoho. 2019 Jan;46(1):157-159.
A70 -year-old man with a diagnosis of panperitonitis caused by colon perforation due to invasion of gallbladder cancer was transferred to our hospital. The next day, an emergency operation was performed. During laparotomy, the ascending colon was perforated; therefore, ileocecal resection was performed. Six hours after the operation, the stoma became ischemic with marked abdominal distention. The intra-abdominal pressure increased to 28 mmHg, and the patient was diagnosed as having abdominal compartment syndrome(ACS). He immediately underwent decompressive laparotomy at bedside. Multiple organ failure was avoided and he recovered, but he died of advanced gallbladder cancer 4 months after the surgery. This case suggests that immediate surgical decompressive laparotomy for ACS can prevent multiple organ failure.
