>Cirugía y Cirujanos
>Year 2008, Issue 6
Tavares-de la Paz LA, Sánchez-Fernández P, Salazar-Lozano C, Salazar-Murillo H
Drenaje percutáneo de ascitis secundaria a pancreatitis aguda grave asociada a síndrome compartimental abdominal. Informe de dos casos
Cir Cir 2008; 76 (6)
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Background: There are few reports that report the association between severe acute pancreatitis (SAP) and the presence of abdominal compartment syndrome (ACS). The aggressive treatment of ACS through a formal celiotomy, ascitic fluid evacuation and temporary abdominal closure (TAC) is associated with immediate improvement in all physiological parameters of a critically ill patient. Unfortunately, this surgical strategy carries a high morbidity and mortality.
Clinical cases: We present two cases of patients with SAP who developed ACS and in whom successful abdominal decompression was achieved, evacuating large volumes of ascitic fluid through a peritoneal catheter. After the evacuation of the ascitic fluid, there was a significant decrease in intraabdominal pressure (IAP) with synchronic improvements in the ventilatory parameters. This allowed us to completely differentiate between the formal and aggressive surgical approach in one of the cases and, in the other, to lengthen the time to surgery.
Conclusions: Abdominal decompression through the evacuation of the ascitic fluid with a peritoneal catheter in patients with SAP and an ACS (secondary to an obligatory massive resuscitation) is a useful and safe surgical strategy to decrease intraabdominal pressure and to differ completely or lengthen the timing of a formal aggressive celiotomy and TAC.
||Abdominal compartment syndrome, severe acute pancreatitis, multiple organ failure, peritoneal catheter.
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>Cirugía y Cirujanos
>Year 2008, Issue 6