Abdominal compartment syndrome

DOI
  • Taniguchi Satoshi
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University
  • Fukuda Wakako
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University
  • Saito Yoshiaki
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University
  • Chiyoya Mari
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University
  • Aoki Chikashi
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University
  • Kondo Norihiro
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University
  • Daitoku Kazuyuki
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University
  • Minakawa Masahito
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University
  • Suzuki Yasuyuki
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University
  • Fukuda Ikuo
    Department of Thoracic and Cardiovascular Surgery, Hirosaki University

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Other Title
  • 腹部大動脈瘤に対するEVARの問題点
  • ─腹部コンパートメント症候群─
  • -an important complication of EVAR in abdominal aortic aneurysm-

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Description

Endovascular Abdominal Aortic Repair (EVAR) for ruptured abdominal aortic aneurysms (rAAAs) has gained acceptance as an alternative to open repair. However, it is still a difficult challenge for patients with unstable hemodynamic conditions. Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are common complications of EVAR for rAAAs that lead to high morbidity and mortality. ACS is an organ dysfunction caused by IAH. IAH is common in rAAA patients because of retroperitoneal hematoma and resultant fluid shifts from massive fluid resuscitation. ACS is diagnosed when there is an evidence of organ dysfunction and the IAP is greater than 20mmHg. Because of increased mortality, a decompression laparotomy is performed. Vacuum-assisted wound closure therapy is recommended because it can potentially decrease the concentration of the bacterial count, and manage third-space fluid. If a Type 2 endoleak is suspected, an additional surgical procedure will save a patient’s life. Appropriate management of ACS is critical in improving rAAA-associated mortality.

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