Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

Introduction Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS,...

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Veröffentlicht in:World journal of surgery 2016-06, Vol.40 (6), p.1454-1461
Hauptverfasser: Smit, M., Buddingh, K. T., Bosma, B., Nieuwenhuijs, V. B., Hofker, H. S., Zijlstra, J. G.
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container_end_page 1461
container_issue 6
container_start_page 1454
container_title World journal of surgery
container_volume 40
creator Smit, M.
Buddingh, K. T.
Bosma, B.
Nieuwenhuijs, V. B.
Hofker, H. S.
Zijlstra, J. G.
description Introduction Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in particular the occurrence of intestinal ischemia. Methods The medical records of all patients admitted with severe acute pancreatitis admitted to the ICU of a tertiary referral center were reviewed. The criteria proposed by the World Society of the Abdominal Compartment Syndrome (WSACS) were used to determine whether patients had IAH or ACS. Results Fifty-nine patients with severe acute pancreatitis were identified. Intra-abdominal pressure (IAP) measurements were performed in 29 patients (49.2 %). IAH was present in all patients (29/29). ACS developed in 13/29 (44.8 %) patients. Ten patients with ACS underwent decompressive laparotomy. A large proportion of patients with ACS had intra-abdominal ischemia upon laparotomy: 8/13 (61.5 %). Mortality was high in both the ACS group and the IAH group. Conclusion This study confirms that ACS is common in severe acute pancreatitis. Intra-abdominal ischemia occurs in a large proportion of patients with ACS. Swift surgical intervention may be indicated when conservative measures fail in patients with ACS. National and international guidelines need to be updated so that routine IAP measurements become standard of care for patients with severe acute pancreatitis in the ICU.
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T. ; Bosma, B. ; Nieuwenhuijs, V. B. ; Hofker, H. S. ; Zijlstra, J. G.</creator><creatorcontrib>Smit, M. ; Buddingh, K. T. ; Bosma, B. ; Nieuwenhuijs, V. B. ; Hofker, H. S. ; Zijlstra, J. G.</creatorcontrib><description>Introduction Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in particular the occurrence of intestinal ischemia. Methods The medical records of all patients admitted with severe acute pancreatitis admitted to the ICU of a tertiary referral center were reviewed. The criteria proposed by the World Society of the Abdominal Compartment Syndrome (WSACS) were used to determine whether patients had IAH or ACS. Results Fifty-nine patients with severe acute pancreatitis were identified. Intra-abdominal pressure (IAP) measurements were performed in 29 patients (49.2 %). IAH was present in all patients (29/29). ACS developed in 13/29 (44.8 %) patients. Ten patients with ACS underwent decompressive laparotomy. A large proportion of patients with ACS had intra-abdominal ischemia upon laparotomy: 8/13 (61.5 %). Mortality was high in both the ACS group and the IAH group. Conclusion This study confirms that ACS is common in severe acute pancreatitis. Intra-abdominal ischemia occurs in a large proportion of patients with ACS. Swift surgical intervention may be indicated when conservative measures fail in patients with ACS. National and international guidelines need to be updated so that routine IAP measurements become standard of care for patients with severe acute pancreatitis in the ICU.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-015-3388-7</identifier><identifier>PMID: 26830909</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Compartment Syndrome ; Abdominal Surgery ; Aged ; Cardiac Surgery ; Decompression, Surgical ; Female ; General Surgery ; Humans ; Intensive Care Unit ; Intestines - blood supply ; Intra-Abdominal Hypertension - etiology ; Intra-Abdominal Hypertension - surgery ; Ischemia - etiology ; Laparotomy ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Multiple Organ Failure ; Original Scientific Report ; Pancreatitis ; Pancreatitis - complications ; Retrospective Studies ; Severe Acute Pancreatitis ; Surgery ; Thoracic Surgery ; Vascular Surgery</subject><ispartof>World journal of surgery, 2016-06, Vol.40 (6), p.1454-1461</ispartof><rights>The Author(s) 2016</rights><rights>2016 The Author(s)</rights><rights>Société Internationale de Chirurgie 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5539-1904a815f1cecb92a09a1e0d81fa11f6d5631d2b523bc96df3bda593cd78c5dd3</citedby><cites>FETCH-LOGICAL-c5539-1904a815f1cecb92a09a1e0d81fa11f6d5631d2b523bc96df3bda593cd78c5dd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-015-3388-7$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-015-3388-7$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,1418,27929,27930,41493,42562,45579,45580,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26830909$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smit, M.</creatorcontrib><creatorcontrib>Buddingh, K. T.</creatorcontrib><creatorcontrib>Bosma, B.</creatorcontrib><creatorcontrib>Nieuwenhuijs, V. B.</creatorcontrib><creatorcontrib>Hofker, H. S.</creatorcontrib><creatorcontrib>Zijlstra, J. G.</creatorcontrib><title>Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Introduction Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in particular the occurrence of intestinal ischemia. Methods The medical records of all patients admitted with severe acute pancreatitis admitted to the ICU of a tertiary referral center were reviewed. The criteria proposed by the World Society of the Abdominal Compartment Syndrome (WSACS) were used to determine whether patients had IAH or ACS. Results Fifty-nine patients with severe acute pancreatitis were identified. Intra-abdominal pressure (IAP) measurements were performed in 29 patients (49.2 %). IAH was present in all patients (29/29). ACS developed in 13/29 (44.8 %) patients. Ten patients with ACS underwent decompressive laparotomy. A large proportion of patients with ACS had intra-abdominal ischemia upon laparotomy: 8/13 (61.5 %). Mortality was high in both the ACS group and the IAH group. Conclusion This study confirms that ACS is common in severe acute pancreatitis. Intra-abdominal ischemia occurs in a large proportion of patients with ACS. Swift surgical intervention may be indicated when conservative measures fail in patients with ACS. National and international guidelines need to be updated so that routine IAP measurements become standard of care for patients with severe acute pancreatitis in the ICU.</description><subject>Abdominal Compartment Syndrome</subject><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Cardiac Surgery</subject><subject>Decompression, Surgical</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Intensive Care Unit</subject><subject>Intestines - blood supply</subject><subject>Intra-Abdominal Hypertension - etiology</subject><subject>Intra-Abdominal Hypertension - surgery</subject><subject>Ischemia - etiology</subject><subject>Laparotomy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Multiple Organ Failure</subject><subject>Original Scientific Report</subject><subject>Pancreatitis</subject><subject>Pancreatitis - complications</subject><subject>Retrospective Studies</subject><subject>Severe Acute Pancreatitis</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkUGL1DAcxYMo7rj6AbxIwYuX6j9JkyYXYRxcHVlQGMVjSJN0J0ubjkm7y3x7U7oOqyB7SuD93uMlD6GXGN5igPpdAiBclIBZSakQZf0IrXBFSUkooY_RCiiv8h3TM_QspWsAXHPgT9FZdlGQIFeoXTd26H3QXbEZ-oOOY-_CWOyOwcahd4UOttiGMepSn8BtMnvXe134UHzTo8-GVNz6cV_s3I2LrlibaXRZCia6rI8-PUdPWt0l9-LuPEc_Lj5-33wuL79-2m7Wl6VhjMoSS6i0wKzFxplGEg1SYwdW4FZj3HLLOMWWNIzQxkhuW9pYzSQ1thaGWUvP0fsl9zA1vbPGzdU7dYi-1_GoBu3V30rwe3U13KhKcCE4yQFv7gLi8GtyaVS9T8Z1nQ5umJLCAggBjDl7GK2FrJmoYUZf_4NeD1PMf7lQuKp4JTOFF8rEIaXo2lNvDGoeXC2Dqzy4mgdXdfa8uv_gk-PPwhmQC3DrO3d8OFH9_LL7cAF1LWcvWbwp28KVi_dq_7fRb8ioyFI</recordid><startdate>201606</startdate><enddate>201606</enddate><creator>Smit, M.</creator><creator>Buddingh, K. 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T.</au><au>Bosma, B.</au><au>Nieuwenhuijs, V. B.</au><au>Hofker, H. S.</au><au>Zijlstra, J. G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2016-06</date><risdate>2016</risdate><volume>40</volume><issue>6</issue><spage>1454</spage><epage>1461</epage><pages>1454-1461</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Introduction Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in particular the occurrence of intestinal ischemia. Methods The medical records of all patients admitted with severe acute pancreatitis admitted to the ICU of a tertiary referral center were reviewed. The criteria proposed by the World Society of the Abdominal Compartment Syndrome (WSACS) were used to determine whether patients had IAH or ACS. Results Fifty-nine patients with severe acute pancreatitis were identified. Intra-abdominal pressure (IAP) measurements were performed in 29 patients (49.2 %). IAH was present in all patients (29/29). ACS developed in 13/29 (44.8 %) patients. Ten patients with ACS underwent decompressive laparotomy. A large proportion of patients with ACS had intra-abdominal ischemia upon laparotomy: 8/13 (61.5 %). Mortality was high in both the ACS group and the IAH group. Conclusion This study confirms that ACS is common in severe acute pancreatitis. Intra-abdominal ischemia occurs in a large proportion of patients with ACS. Swift surgical intervention may be indicated when conservative measures fail in patients with ACS. National and international guidelines need to be updated so that routine IAP measurements become standard of care for patients with severe acute pancreatitis in the ICU.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>26830909</pmid><doi>10.1007/s00268-015-3388-7</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Abdominal Compartment Syndrome
Abdominal Surgery
Aged
Cardiac Surgery
Decompression, Surgical
Female
General Surgery
Humans
Intensive Care Unit
Intestines - blood supply
Intra-Abdominal Hypertension - etiology
Intra-Abdominal Hypertension - surgery
Ischemia - etiology
Laparotomy
Male
Medicine
Medicine & Public Health
Middle Aged
Multiple Organ Failure
Original Scientific Report
Pancreatitis
Pancreatitis - complications
Retrospective Studies
Severe Acute Pancreatitis
Surgery
Thoracic Surgery
Vascular Surgery
title Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis
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