Lumbar paraspinal compartment syndrome.

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Abstract

[Indexed for MEDLINE] 15. J Visc Surg. 2021 Oct;158(5):411-419. doi: 10.1016/j.jviscsurg.2021.01.001. Epub 2021 Jan 28. Management of abdominal compartment syndrome in acute pancreatitis. Siebert M(1), Le Fouler A(2), Sitbon N(2), Cohen J(3), Abba J(4), Poupardin E(2). Author information: (1)Department of Surgery, GHI Le Raincy-Montfermeil, 93370 Montfermeil, France; Department of general surgery and emergency surgery, CHU de Grenoble, Grenoble, France. Electronic address: siebertmatthieu@gmail.com. (2)Department of Surgery, GHI Le Raincy-Montfermeil, 93370 Montfermeil, France. (3)Multipurpose intensive care unit, GHI Le Raincy-Montfermeil, 93370 Montfermeil, France. (4)Department of general surgery and emergency surgery, CHU de Grenoble, Grenoble, France. Abdominal compartment syndrome (ACS), defined by the presence of increased intra-abdominal pressure>20mmHg in association with failure of at least one organ system, is a common and feared complication that may occur in the early phase of severe acute pancreatitis (AP). This complication can lead to patient death in the very short term. The goal of this review is to provide the surgeon and intensivist with objective information to help them in their decision-making. In the early phase of severe AP, it is essential to monitor intra-vesical pressure (iVP) to allow early diagnosis of intra-abdominal hypertension or ACS. The treatment of ACS is both medical and surgical requiring close collaboration between the surgical and resuscitation teams. Medical treatment includes vascular volume repletion, prokinetic agents, effective curarization and percutaneous drainage of large-volume ascites. If uncontrolled respiratory or cardiac failure develops or if maximum medical treatment fails, most teams favor performing an emergency xipho-pubic decompression laparotomy with laparostomy. This procedure follows the principles of abbreviated laparotomy as described for abdominal trauma. Copyright © 2021 Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.jviscsurg.2021.01.001