Case of Abdominal Compartment Syndrome Treated by using a Bedside Open Linea Alba Fasciotomy

외상에 의한 후복막 출혈환자에서 발생한 복부구획증후군을 침상 옆 백선 근막 절개술로 치료한 증례

  • Kim, Ji-Hoon T. (Department of Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Han, Myung-Sik (Department of Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Choi, Gun-Moo (Department of Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Jang, Hyuck-Jae (Department of Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Kwak, Jin-Ho (Department of Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Kim, Ji-Hoon S. (Department of Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital)
  • 김지훈 (울산대학교 의과대학 강릉아산병원 외과) ;
  • 한명식 (울산대학교 의과대학 강릉아산병원 외과) ;
  • 최건무 (울산대학교 의과대학 강릉아산병원 외과) ;
  • 장혁재 (울산대학교 의과대학 강릉아산병원 외과) ;
  • 곽진호 (울산대학교 의과대학 강릉아산병원 외과) ;
  • 김지훈 (울산대학교 의과대학 강릉아산병원 외과)
  • Received : 2010.12.08
  • Accepted : 2011.05.17
  • Published : 2011.06.30

Abstract

Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intra-abdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.

Keywords

References

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