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Abdominal Compartment Syndrome in Children: Experience with Five Cases - Abstract

Hussein Naji

 

Abstract

Background

Abdominal compartment syndrome is the adverse physiologic consequence that occurs as a result of a sever increase in intra-abdominal pressure, leading to cardiopulmonary, renal and splanchnic disturbance regardless of the cause. This article highlights our experience with abdominal compartment syndrome in children and focuses on the role of abdominal decompression as its management.

Patients and method

Retrospectively, we reviewed the files of 5 children who were treated in our unit for abdominal compartment syndrome. Two of them were neonates, one infant and the other 2, 7 and 10 years old, respectively. Each child presented in a different way, required massive fluid resuscitation, and had tense abdominal distension. Each clinical scenario will be described and the management will be outlined.

Results

Apart from one child with multiple organ injury, the rest showed immediate improvement in the respiratory, renal, and hemodynamic function, after abdominal decompression. When the measurement of intra-abdominal pressure is not feasible, the clinical signs of tensely distended abdomen, hypoxia and respiratory distress, progressive oliguria and cyanosis of the lower extremities, are sufficient to make the diagnosis of abdominal compartment syndrome and to justify decompression.

Conclusions

Abdominal compartment syndrome is a potentially lethal condition and may be the consequence of a variety of conditions. Increased awareness of abdominal compartment syndrome may prevent its occurrence and its lethal consequences. Intra-abdominal pressure should be monitored closely, when possible, otherwise decompression should be considered depending on the clinical signs.

Keywords: abdominal compartment syndrome, intra-abdominal pressure, hemodynamic parameters, clinical signs

 

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