Eom Byeong Hun, Lim Hyun Kyoung, Tae Nayoung, Shinn Helen Ki
Department of Anesthesiology and Pain Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
Anesth Pain Med (Seoul). 2020 Apr 30;15(2):251-258. doi: 10.17085/apm.2020.15.2.251. Epub 2020 Apr 29.
Abdominal compartment syndrome (ACS) occurs due to increased abdominal cavity pressure, causes multiple organ damage, and leads to fatal consequences. Increased intraperitoneal pressure due to different reasons generally does not result in serious damage, due to the compliance of the abdominal wall. However, when the pressure exceeds the limit, ACS develops, thereby causing fatal damage to the organs.
A patient presented with rapid stomach swelling due to excessive food intake and was known to have bulimia nervosa, which had now resulted in ACS. Mental changes, abdominal distension, color change in the legs, acute kidney injury, and acidosis were seen. The patient expired due to ischemia-reperfusion injury and disseminated intravascular coagulation, which occurred after surgical decompression.
Under suspected ACS conditions, we should be aware of various symptoms that can occur. Early attempts for decompression are helpful, and it is important to be prepared for reperfusion injury prior to surgical decompression attempts.
腹腔间隔室综合征(ACS)是由于腹腔压力升高引起的,会导致多器官损伤,并导致致命后果。由于腹壁的顺应性,不同原因导致的腹腔内压力升高一般不会造成严重损害。然而,当压力超过极限时,就会发展为ACS,从而对器官造成致命损害。
一名因暴饮暴食导致胃部迅速肿胀的患者,已知患有神经性贪食症,现已发展为ACS。出现了精神变化、腹胀、腿部颜色改变、急性肾损伤和酸中毒。患者在手术减压后因缺血再灌注损伤和弥散性血管内凝血而死亡。
在怀疑患有ACS的情况下,我们应该意识到可能出现的各种症状。早期进行减压尝试是有帮助的,并且在进行手术减压尝试之前,为再灌注损伤做好准备很重要。