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2008, Number 6

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Cir Cir 2008; 76 (6)

Drenaje percutáneo de ascitis secundaria a pancreatitis aguda grave asociada a síndrome compartimental abdominal. Informe de dos casos

Tavares-de la Paz LA, Sánchez-Fernández P, Salazar-Lozano C, Salazar-Murillo H

Language: Spanish
References: 33
Page: 515-518
PDF size: 44.48 Kb.


ABSTRACT

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.


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