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伴有乙状结肠扭转的腹腔间隔室综合征:失去的时间就是逝去的生命。

Abdominal Compartment Syndrome (ACS) With Sigmoid Volvulus (SV): Lost Hours Are Lost Lives.

作者信息

Marin Andrea C, Hechter Sharon, Prasad Ankita, Alnabwani Dina, Lwoodsky Charles, Cheriyath Pramil

机构信息

Internal Medicine, Hackensack Meridien Health Ocean Medical Center, Brick, USA.

Internal Medicine, Hackensack Meridian Health Ocean Medical Center, Brick, USA.

出版信息

Cureus. 2023 Jan 13;15(1):e33741. doi: 10.7759/cureus.33741. eCollection 2023 Jan.

Abstract

Normal intra-abdominal pressure (IAP) ranges from 0 to 5, and abdominal compartment syndrome (ACS) occurs when a sustained IAP >20 mmHg causes organ dysfunction. ACS mainly occurs in patients who are critically ill. It occurs due to an injury or disease in the abdomen or pelvic area, including trauma, abdominal surgery, acute pancreatitis, pancreatic ileus, volvulus, fecal impaction, and ruptured abdominal aortic aneurysm. If not recognized early, ACS leads to multiorgan dysfunction, shock, and sepsis and has high morbidity and mortality. Our patient was brought to the emergency department (ED) following cardiac arrest and resuscitation and was diagnosed with sigmoid volvulus (SV) and ACS. SV is seen in older men, and its presentation is often insidious and leads to bowel gangrene and ACS. The patient's delay in presenting to the hospital and the severity of his condition leads to a poor outcome despite surgery. A delay in recognizing ACS can lead to a worse outcome.

摘要

正常腹腔内压力(IAP)范围为0至5,当持续的IAP>20 mmHg导致器官功能障碍时,会发生腹腔间隔室综合征(ACS)。ACS主要发生在重症患者中。它是由腹部或骨盆区域的损伤或疾病引起的,包括创伤、腹部手术、急性胰腺炎、麻痹性肠梗阻、肠扭转、粪便嵌塞和腹主动脉瘤破裂。如果不及早识别,ACS会导致多器官功能障碍、休克和脓毒症,发病率和死亡率都很高。我们的患者在心脏骤停和复苏后被送往急诊科(ED),被诊断为乙状结肠扭转(SV)和ACS。SV多见于老年男性,其表现往往隐匿,会导致肠坏疽和ACS。尽管进行了手术,但患者就医延迟且病情严重,导致预后不良。未能及时识别ACS会导致更差的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbcb/9922519/2c75b01d9529/cureus-0015-00000033741-i01.jpg

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