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European Surgery
Erschienen in:

01.02.2013 | Case Report

Conservative treatment of abdominal compartment syndrome after large ventral hernia repair

verfasst von: M. Bezmarevic, MD, D. Slavkovic, MD, B. Trifunovic, MD, PhD, N. Stankovic, MD, PhD, S. Mickovic, MD, B. Neskovic, MD, J. Beloica, MD

Erschienen in: European Surgery | Ausgabe 1/2013

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Summary

Background

Surgical repair of large ventral hernias has become feasible after introduction of synthetic meshes and development in intensive-care treatment. In addition to operative challenges, the postoperative disorders incurred as the consequences of increased intra-abdominal pressure (IAP) still expose patients to severe risks.

Case report

A 44-year-old man was admitted in our institution for the large ventral hernia repair. Despite large ventral hernia with thickened subcutaneous tissue above hernia sac, a relatively small primary defect that was easy to repair was found on abdominal computed tomography. Intra-operatively, the primary defect was 10 cm in diameter with preserved abdominal front wall layers around it. The hernia sac was resected and ventral hernioplasty was performed with Prolene® mesh. IAP, measured intra-operatively and after extubation of the patient, was normal. On the second postoperative day, the patient was intubated due to respiratory failure in development of abdominal compartment syndrome (ACS). This condition was treated conservatively and he was extubated on the sixth postoperative day. The subsequent course was uneventful and the patient was discharged 14 days after the surgery with significant improvement in his mobility.

Results and conclusions

Relatively small abdominal wall defect of large ventral hernia made surgery less complicated than assumed on the first presentation. The most important determinants of the postoperative complications were the mismatch of the original abdominal cavity and the mass of tissue with loss of domain. Conservative treatment of IAH/ACS should be implemented as early as possible, which can lead to the resolution of ACS as presented in our case.
Vorheriger Artikel DG-RAR for the treatment of symptomatic grade III and grade IV haemorrhoids: a 12-month multi-centre, prospective observational study
Nächster Artikel Myoid hamartoma of the breast: case report
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Metadaten
Titel
Conservative treatment of abdominal compartment syndrome after large ventral hernia repair
verfasst von
M. Bezmarevic, MD
D. Slavkovic, MD
B. Trifunovic, MD, PhD
N. Stankovic, MD, PhD
S. Mickovic, MD
B. Neskovic, MD
J. Beloica, MD
Publikationsdatum
01.02.2013
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 1/2013
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-012-0168-6

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