EMERGENCY RE–EXPLORATION AND DECOMPRESSION IN ABDOMINAL COMPARTMENT SYNDROME BY MEASURING INTRA–ABDOMINAL PRESSURE.

DR .VIJAYAKUMAR .G; Dr. SHARATH B.V; Dr. KUMARASWAMY. R.C; Dr. PRADEEP KUMAR. J; DR. VIJAYALAXMI. J. D

Volume : III, Issue : XII, December - 2014

EMERGENCY RE–EXPLORATION AND DECOMPRESSION IN ABDOMINAL COMPARTMENT SYNDROME BY MEASURING INTRA–ABDOMINAL PRESSURE.

Dr . Vijayakumar . G, Dr. Sharath B. V, Dr. Kumaraswamy. R. C, Dr. Pradeep Kumar. J, Dr. Vijayalaxmi. J. D

Abstract :

OBJECTIVE: Objective of the study was to identify the patients who need emergency re exploration and decompression in abdominal compartment syndrome by measuring intra abdominal pressure. PATIENTS AND METHODS: Prospective study of intra-abdominal pressure measurement of forty five patients during first three post operative days, treated for various non-traumatic emergency conditions during December 2010 to August 2014 in a tertiary care centre by measuring intra-cystic pressure by using a Foley�s catheter and a water manometer. Variables such as age, heart rate, respiratory rate, mean blood pressure, PaO2, Urine output, duration of surgery, nature of closure and time taken to re-explore and to decompress the abdomen were also studied. RESULTS : Of 45 postoperative patients acute elevation of the intra-abdominal pressure above 20mmHg caused oliguria in all. Patients with Grade II and Grade III with IAP <30mmHg and oliguria improved with diuretics and conservative management except one who died of cardiorespiratory arrest. Operative re-exploration and decompression were done in 10 patients with IAP more than 30mmHg resulted in improved diuresis in 7 patients and three died because of continued renal failure. CONCLUSION: Patients with intra-abdominal pressure above 30mmHg and oliguric should undergo early re-exploration and decompression to have an improved outcome.