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At least 703 records · Page 39Linked to original sources
PubMed2003

Abdominal wall closure with ePTFE--Goretex Dual Mesh after detensive laparotomy for abdominal compartment syndrome.

INTRODUCTION: Detensive laparotomy is the first choice treatment for abdominal compartment syndrome (ACS). Tension free closure of the abdominal wall with the use of prosthesis is a broadly diffused technique; the polypropylene and the ePTFE (expanded polytetrafluoroethylene--Goretex Dual Mesh) are the most commonly used materials. MATERIALS AND METHODS: We report our experience on five patients affected by ACS submitted to detensive laparotomy and positioning of a wide Goretex Dual Mesh prosthesis. RESULTS: In our initial experience ACS has been treated with success through detensive laparotomy and there were no complications related to the use of Goretex. DISCUSSION: Even though limited, our initial clinical experience is favorable to the use of Goretex Dual Mesh as first choice material for reconstruction of the abdominal wall after detensive laparotomy for ACS.

Abdominal Cavity↗
PubMed2006

Secondary abdominal compartment syndrome: a potential threat for all trauma clinicians.

Post-injury abdominal compartment syndrome (ACS) is an increasingly recognised phenomenon in critical care. During the last decade, ACS had also been characterised in patients without abdominal injuries, referred to as secondary ACS. Recent investigation has described this elusive syndrome better, with up to 70% mortality. Regardless of the cause of the syndrome and the nature of any extra-abdominal injuries, secondary ACS is invariably associated with massive fluid resuscitation. With a reliable, predictive model and new monitoring techniques, trauma clinicians should be able to identify the high-risk patient and attenuate the impact of this syndrome.

Abdominal Injuries↗
PubMed2003

Abdominal compartment syndrome: the cause or effect of postinjury multiple organ failure.

Abdominal compartment syndrome (ACS) has emerged to be a significant problem in patients who develop postinjury multiple organ failure (MOF). Current laboratory research suggests that ACS could be a second hit for the development of MOF. Recent studies demonstrate that ACS is an independent predictor of MOF and that the prevention of ACS decreases the incidence of MOF. The Trauma Research Centers at the University of Colorado and the University of Texas-Houston Medical School are focused on defining the role of the gut in postinjury MOF. Because ACS is a plausible modifiable risk factor, our interest has been to 1) describe the epidemiology of ACS, 2) build prediction models, 3) provide strategies for prevention and treatment of ACS, and 4) develop relevant laboratory models. This review summarizes our findings.

Abdomen↗
PubMed1983

Compartment syndromes. Early diagnosis and a bedside operation.

Delays in diagnosis and treatment of compartment syndromes of the lower extremities result in significant morbidity and mortality. Knowledge of the anatomy of the lower leg compartments provides clues to earlier diagnosis as to the specific compartments involved in these syndromes. A simple physical examination is described that focuses on this. Furthermore, a simple "bedside" operation is described that provides excellent decompression of all of these compartments without fibulectomy.

Adult↗
PubMed2006

Morphology, TNFalpha expression and apoptosis in the hearts of patients who died of abdominal compartment syndrome: an immunohistochemical study.

Most of the existing reports on abdominal compartment syndrome (ACS) deal with pathophysiology, focusing on its clinical picture and course, and knowledge of the histopathological features of ACS is very poor. Since the heart, kidneys and lungs are the organs primarily targeted for injury in multi-organ failure, we investigated the expression of TNFalpha and apoptosis in tissue specimens of the heart. This retrospective study was conducted at the Department of Forensic Pathology, University of Foggia. A retrospective review of records extending over a period of 4 years, from 1 April 2001 to 31 March 2005, was carried out and all cases subjected to medico-legal autopsy during this period, whose detailed history and case records were available, were the subjects of our study. Over a 4-year period, on 848 cases subjected to medico-legal autopsy, three cases qualified for inclusion into the study. The immunohistochemical study revealed an intensive positive result for TNFalpha in heart specimens. The TUNEL assay was positive in heart specimens too. The presented study can contribute to elucidate the pathophysiology of fatal ACS and also define efficient markers for future therapeutic approaches suggesting anti-TNFalpha strategies may be useful in the management of ACS.

Abdomen↗
PubMed2006

Identification and management of Abdominal Compartment Syndrome in the Pediatric Intensive Care Unit.

OBJECTIVE: Asses if Abdominal Compartment Syndrome (ACS) increases the morbidity and mortality of the Pediatric Intensive Care Unit patients and if early recognition and intervention with decompressive therapy will alter outcome and decrease mortality. SETTING: Pediatric Intensive Care Unit of the University Pediatric Hospital-UPR. PATIENTS: All patients admitted to the PICU from July 1, 1999 to June 30, 2002 were enrolled in the study. Those having a distended and/or tense abdomen on physical examination were identified at risk for intra-abdominal hypertension (IAH). IAH was diagnosed if the intra-abdominal pressure (IAP) was above 10 mmHg and with ACS if the IAH was accompanied by: hemodynamic instability, oliguria or anuria, metabolic acidosis and respiratory deterioration. MEASUREMENTS AND MAIN RESULTS: 1052 patients were admitted to PICU. Ten patients with evidence of ACS were identified with an incidence of 0.9%. Ages ranged from 6 weeks to 12.3 years. Peak intravesical pressure measurements ranged from 17 to 39 mmHg. Inspiratory pressure was raised from a mean of 21.2 to 32.0 cmH2O. The PCO2 increased from a mean of 35.1 to 63 torr and the pH decreased from a mean of 7.40 to 7.12. Overall mortality was 40% for this patient population. CONCLUSIONS: The outcome of pediatric critical care patients depends on multiple variables. Now there is evidence that in a select group of patients IAH and ACS play a significant role in their morbidity and mortality. This makes it mandatory for clinicians taking care of this population to be increasingly aware of this condition.

Abdomen↗
PubMed2006

Compartment syndrome in the hand due to extravasation of contrast material.

Extravasation of contrast material is a well-recognized complication of contrast-enhanced imaging studies. Most extravasations result only in minimal swelling or erythema; however, severe skin necrosis, ulceration and compartment syndrome may occur with extravasation of large volumes. This article presents a patient in whom extravasation developed after computed tomography (CT) contrast material was injected intravenously in the dorsum of the hand. Compartment syndrome was diagnosed, and the patient underwent fasciotomy. In follow-up, the patient regained full use of the hand. Although the use of contrast material has significantly improved the diagnostic accuracy of CT, anaphylaxis and contrast material extravasation are important complications. Selection of non-ionic contrast material, careful evaluation of the intravenous administration site and close monitoring of the patient during contrast material injection may help minimize or prevent extravasation injuries.

Aged↗
PubMed1990

Capillary leakage complicated by compartment syndrome necessitating surgery.

A single episode of systemic capillary leak syndrome is reported in a HIV-positive patient. The shock had necessitated the infusion of large amounts of fluid with concomitant diffuse swelling and weight gain leading to compartment syndrome of both legs. This required surgical relief. The initial high hematocrit (62%) and low serum protein concentration (48 g/l) with normal factor V (molecular weight above 300,000) concentrations are the hallmark of capillary leak when they are associated with hypovolemic shock. It must be emphasized that fluid resuscitation may worsen the muscle damage with ultimate compartment syndrome. Therefore, it appears reasonable to monitor muscular pressure during volume expansion in patients with capillary leak syndrome, severe shock and muscular swelling.

Adult↗
PubMedDate not supplied

[Snake bite poisoning and compartment syndrome. A report of two cases].

Snakebite poisonings are frequent In Morocco, because of the delay in treatment, they can be very serious even lethal. Treatment has two components: firstly correction of the systemic hemodynamic, respiratory and haematological disturbances and secondly administration of specific antivenom. Envenomation of a limb can lead to cutaneous necrosis, compartment syndrome and even necrotising fascitis. Early diagnosis and prompt treatment is needed to prevent these complications. We report two cases of compartment syndrome of which one was combined with systemic manifestations and the other caused residual pathology in the limb.

Adolescent↗
PubMed1995

The effects of elevated compartment pressure on tibial arteriovenous flow and relationship of mechanical and biochemical characteristics of fascia to genesis of chronic anterior compartment syndrome.

PURPOSE: The purpose of this study is to evaluate the effects of increased compartment pressure on anterior tibial arteriovenous flow patterns and to determine whether mechanical and biochemical properties of fascia are responsible for compartment pressure abnormalities. METHODS: Twenty patients with chronic anterior compartment syndrome (CACS) and 20 age-matched control subjects had compartment pressure measurements and analysis of tibial arterial and venous flow before and after fasciectomy. Fascia specimens were evaluated for thickness, stress failure, structural stiffness, and total collagen content and prevalence of collagen cross-linkage. RESULTS: Pressures were significantly elevated in patients with CACS versus control subjects (23.8 mm Hg vs 6 mm Hg). No significant difference in tibial arterial flow could be detected in either group (43 cm/sec mean vs 41.9 cm/sec mean). Venous drainage was severely impaired in patients with CACS but not in control subjects. CACS fascia was thicker and stiffer than control fascia specimens (0.35 mm +/- 0.12 mm, 109 +/- 65 MN/mm; versus 0.22 mm +/- 0.06 mm; 60.3 +/- 22 MN/mm). Fasciectomy normalized postoperative compartment pressures and improved venous drainage. Collagen content per unit mass was similar for both CACS and control fascia specimens, although collagen cross-linking was significantly lower in the CACS fascia than in the controls. CONCLUSIONS: Tibial venous drainage is impaired, but arterial flow is not in patients with CACS. Fascia thickness and structural stiffness can account for increased pressure in CACS compartments. Collagen content and cross-linkage are unrelated to fascia stiffness or thickness. Postoperative improvement in vascular hemodynamics and reduction in compartment pressure is caused by increased capacitance in the compartment after fasciectomy.

Anterior Compartment Syndrome↗
PubMed2003

The abdominal compartment syndrome following aortic surgery.

BACKGROUND: multi-organ failure is a leading cause of death following aneurysm surgery, especially in the emergency setting. Intra-abdominal hypertension is an important factor in the development of multi-organ failure. Prevention, early recognition and prompt treatment of abdominal hypertension and the abdominal compartment syndrome may reduce mortality following aneurysm surgery. METHODS: a descriptive review of the literature from a Medline search. RESULTS AND CONCLUSIONS: the abdominal compartment syndrome is the result of diverse physiological effects caused by increased intra-abdominal pressure. The syndrome has been most widely described in trauma victims, but occurs in patients following aortic surgery, particularly following ruptured aneurysm repair. Preventative therapy should be instituted to minimise its development in patients at risk, and monitoring of intra-abdominal pressure may allow prompt treatment of this condition.

Abdomen↗
PubMed1989

Compartment syndrome in combined arterial and venous injuries of the lower extremity.

In 9 of 45 patients treated for dual vascular injuries of the lower extremity, concomitant fasciotomies were performed at the time of initial surgery for associated soft tissue injury, fracture, or prolonged ischemia. Eight other patients developed compartment syndrome requiring delayed fasciotomy. In seven of them, vein was either ligated or the repaired vein became occluded. In the eighth patient, peripheral venous hypertension was caused by massive swelling of the thigh. In the laboratory, compartment pressure was monitored by wick catheter in 24 hind limbs of 12 dogs subjected to experimental conditions simulating vascular injuries and their management. There was a significant increase in compartment pressure in a group that simulated arterial and venous injuries managed by arterial repair and venous outflow obstruction. Based on our study, we suggest that obstruction to venous drainage and venous hypertension are major factors in the development of compartment syndrome in dual vascular injuries of the lower extremity.

Adolescent↗
PubMed1987

Compartment syndrome: a complication of use of the MAST suit.

A case of compartment syndrome following the use of a MAST suit is reported. The most significant factor in its development is prolonged application combined with severe hemodynamic compromise. Amputation was performed or death occurred in 50% of reported cases. Compartment pressure monitoring should be done in patients who require a MAST suit for more than 4 h.

Adolescent↗
PubMed2002

A snake in the clinical grass: late compartment syndrome in a child bitten by an adder.

Snakebite envenomation is an uncommon condition in the UK, but requires vigilance with regard to both the systemic effects of the venom and the locoregional impact on the soft tissues. We describe a case requiring delayed fasciotomies for closed compartment syndrome of the leg and thigh, and discuss in detail the controversies surrounding decompression in such a case. Adder bites are uncommon in the UK, but can result in envenomation of varying severity. Apart from the numerous possible systemic effects that require attention, there are local effects that, very rarely, can be limb threatening. Of these, elevated limb compartment pressures are of paramount importance, and recognition of closed compartment ischaemia is vital if the limb is to be saved by surgical decompression. Guidelines on threshold compartment pressures and fasciotomies are indistinct regarding snakebite, with diagnostic emphasis still placed on clinical signs and symptoms. In the paediatric setting, measurement of compartment pressures is a valuable adjunct to clinical suspicion in the diagnosis of acute compartment syndrome secondary to snakebite.

Animals↗
PubMed2000

Abdominal compartment syndrome in a patient with congenital megacolon.

A 13-year-old male with a history of chronic congenital megacolon presented to the emergency department with a 1-day history of increasing abdominal pain, distension, and emesis. The patient was admitted for bowel disimpaction and irrigation. The patient rapidly developed an acute abdominal compartment syndrome because of his massive colonic dilation. Surgical decompression resulted in a reperfusion phenomenon and ultimately resulted in coagulopathy and patient demise. This case presents a unique cause of the abdominal compartment syndrome and discusses the implications to the emergency physician.

Abdomen↗
PubMed1988

The compartment syndrome. An experimental and clinical study of muscular energy metabolism using phosphorus nuclear magnetic resonance spectroscopy.

In an experimental ischemic compartment syndrome in dogs, phosphorus (31P) nuclear magnetic resonance (NMR) spectroscopy was used to determine the tissue pressure threshold at which resting skeletal muscle begins to use anaerobic energy sources due to insufficient cellular oxygen delivery. The interactive effects of systemic perfusion pressure and moderate muscle trauma on this anaerobic threshold were also evaluated. The severity of cell injury produced by various degrees of compartment pressurization over an eight-hour period was concomitantly studied using muscle biopsy and electron microscopy. Clinical correlation of a preliminary patient series studied using 31P-NMR demonstrated that the threshold for cellular metabolic derangement in skeletal muscle subjected to increased tissue pressure was more closely associated with the difference between mean arterial blood pressure (MABP) and compartment pressure than with the absolute compartment pressure alone. The difference is termed MABP-compartment pressure, or delta P. The lowest delta P at which a normal cellular metabolic state can be maintained is approximately 30 mmHg in normal muscle and 40 mmHg in moderately traumatized muscle. It is imperative to interpret compartment pressure measurements in light of the degree of soft tissue trauma sustained and the patient's blood pressure, as well as the clinical signs and symptoms.

Animals↗
PubMed1987

Bilateral intrinsic compartment syndrome of the hands in an 18-month-old child.

Intrinsic compartment syndrome of the hands is a relatively rare phenomenon. When it does occur, prompt recognition and early treatment are essential for a favorable outcome. The bilateral occurrence of this phenomenon is extremely rare; to the best of our knowledge it has not previously been described in a young child. We present a case of bilateral occurrence involving all intrinsic compartments of both hands in an 18-month-old child. Early diagnosis, prompt surgical decompression, and early postoperative rehabilitation provided a favorable, functional outcome.

Compartment Syndromes↗