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KMID : 1033220110010010034
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Journal of Acute Care Surgery
2011 Volume.1 No. 1 p.34 ~ p.39
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Temporary Abdominal Closure in Patients with a Risk of Developing Abdominal Compartment Syndrome
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Park Chan-Yong
Ju Jae-Kyun
Kim Jung-Chul
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Abstract
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The concepts of intra.abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have only been developed in intensive care in the last 10 years. The World Society of the Abdominal Compartment Syndrome (WSACS) defined IAH as an intra.abdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAH and ACS are rare conditions with high mortality. The IAH contributes to organ failure in patients with abdominal trauma and sepsis and leads to the development of ACS. The most common causes of IAH are massive fluid resuscitation after major injuries or burns, and ischemia of intestines after major vascular surgery. In confirmed cases of IAH and/or ACS, immediate action should be taken. It consists of evacuation of intraluminal contents, evacuation of intra.abdominal space occupying lesions, improvement of abdominal wall compliance, optimization of fluid administration, and optimization of systemic and regional perfusion. Decompressive laparotomy followed by temporary abdominal closure (TAC) has commonly been indicated in the management of severe trauma patients to avoid ACS and as part of damage control surgery. We report two cases who undertook TAC owing to the severe bowel edema secondary to massive bleeding. The one is total transaction of the right common iliac artery and another is AAST grade IV liver injury.
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KEYWORD
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Intra.abdominal hypertension, Abdominal compartment syndrome, Temporary abdominal closure
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