Itakura Ryuta, Takayanagi Natsuko, Kobayashi Shingo, Sakurai Yoshio, Iwamoto Yoichi, Ishido Hirotaka, Moriwaki Koichi, Tamaru Jun-Ichi, Masutani Satoshi
Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Department of Pathology, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Am J Case Rep. 2019 Jul 13;20:1011-1015. doi: 10.12659/AJCR.915296.
BACKGROUND Abdominal compartment syndrome (ACS), characterized by an increased intra-abdominal pressure and new-onset organ dysfunction, is a critical and potentially fatal condition, with no case of ACS caused by intestinal gas without intestinal lesion being reported to date. CASE REPORT A 2-year-old girl with a chromosomal abnormality of 1p36 deletion presented with fever and diarrhea following upper-gastrointestinal series for the evaluation of gastroesophageal reflux. After 20 days, she experienced septic shock and multiple-organ failure, accompanied with rapidly growing, severe abdominal distension. A marked increase in the intra-abdominal pressure was indicated by the complete loss of elasticity in the extremely hard and distended abdomen. She died 14 h after the onset of shock. Her autopsy examination revealed extensive pneumonia and excessive intestinal gas, despite no occlusive intestinal lesion present. CONCLUSIONS It is critical to be aware that secondary ACS can occur following sepsis due to the accumulation of extensive intestinal gas, without an occlusive intestinal lesion.
腹腔间隔室综合征（ACS）以腹内压升高和新发器官功能障碍为特征，是一种危急且可能致命的病症，迄今为止尚无无肠道病变的肠气引起ACS的病例报道。病例报告：一名患有1p36缺失染色体异常的2岁女孩，在接受上消化道造影以评估胃食管反流后出现发热和腹泻。20天后，她发生感染性休克和多器官功能衰竭，伴有迅速加重的严重腹胀。极度坚硬且膨胀的腹部完全失去弹性，提示腹内压显著升高。休克发作14小时后她死亡。尸检显示尽管没有闭塞性肠道病变，但存在广泛肺炎和过多肠气。结论：必须认识到，在没有闭塞性肠道病变的情况下，由于广泛肠气积聚，脓毒症后可能发生继发性ACS。
