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Erschienen in: European Surgery 1/2013

01.02.2013 | Case Report

Conservative treatment of abdominal compartment syndrome after large ventral hernia repair

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

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.

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Literatur
1.
Zurück zum Zitat Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed). 1982;284(6364):519–20. Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed). 1982;284(6364):519–20.
2.
Zurück zum Zitat George CD, Ellis H. The results of incisional hernia repair: a twelve year review. Ann R Coll Surg Engl. 1986;68(4):185–7. PubMed George CD, Ellis H. The results of incisional hernia repair: a twelve year review. Ann R Coll Surg Engl. 1986;68(4):185–7. PubMed
3.
Zurück zum Zitat Luijendijk RW, Hop WC, Van Den Tol MP, et al. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med. 2000;343(6):392–8. PubMedCrossRef Luijendijk RW, Hop WC, Van Den Tol MP, et al. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med. 2000;343(6):392–8. PubMedCrossRef
4.
Zurück zum Zitat Burger JW, Luijendijk RW, Hop WC, et al. Long term follow up of a randomized controlled trial of suture versus mesh repair of incisonal hernia. Ann Surg. 2004;240(4):578–83. (discussion:583–5). PubMed Burger JW, Luijendijk RW, Hop WC, et al. Long term follow up of a randomized controlled trial of suture versus mesh repair of incisonal hernia. Ann Surg. 2004;240(4):578–83. (discussion:583–5). PubMed
5.
Zurück zum Zitat Reichenberger MA, Stoff A, Richter DF. Dealing with the mass: a new approach to facilitate panniculectomy in patients with very large abdominal aprons. Obes Surg. 2008;18:1605–10. PubMedCrossRef Reichenberger MA, Stoff A, Richter DF. Dealing with the mass: a new approach to facilitate panniculectomy in patients with very large abdominal aprons. Obes Surg. 2008;18:1605–10. PubMedCrossRef
6.
Zurück zum Zitat Langer S, Christiansen J. Long-term results after incisional hernia repair. Acta Chir Scand. 1985;151:217–9. PubMed Langer S, Christiansen J. Long-term results after incisional hernia repair. Acta Chir Scand. 1985;151:217–9. PubMed
7.
Zurück zum Zitat Anthony T, Bergen PC, Kim LT. Factors affecting recurrence following incisional herniorrhaphy. World J Surg. 2000;24(1):95–101. PubMedCrossRef Anthony T, Bergen PC, Kim LT. Factors affecting recurrence following incisional herniorrhaphy. World J Surg. 2000;24(1):95–101. PubMedCrossRef
8.
Zurück zum Zitat Leber GE, Garb JL, Alexander AJ, et al. Long term complications associated with prosthetic repair of incisional hernias. Arch Surg. 1998;133(4):378–82. PubMedCrossRef Leber GE, Garb JL, Alexander AJ, et al. Long term complications associated with prosthetic repair of incisional hernias. Arch Surg. 1998;133(4):378–82. PubMedCrossRef
9.
Zurück zum Zitat Deysine M. Ventral herniorrhaphy: treatment evolution in a hernia service. Hernia. 1998;2:15–8. CrossRef Deysine M. Ventral herniorrhaphy: treatment evolution in a hernia service. Hernia. 1998;2:15–8. CrossRef
10.
Zurück zum Zitat Shell DH, Torre J, Andrades P, Vasconez LO. Open repair of ventral incisional hernias. Surg Clin N Am. 2008;88:61–3. PubMedCrossRef Shell DH, Torre J, Andrades P, Vasconez LO. Open repair of ventral incisional hernias. Surg Clin N Am. 2008;88:61–3. PubMedCrossRef
11.
Zurück zum Zitat Tanaka EY, Yoo JH, Rodrigues AJ, et al. A computerized tomography scan method for calculating the hernia sac and abdominal cavity volume in complex large incisional hernia with loss of domain. Hernia. 2010;14:63–9. PubMedCrossRef Tanaka EY, Yoo JH, Rodrigues AJ, et al. A computerized tomography scan method for calculating the hernia sac and abdominal cavity volume in complex large incisional hernia with loss of domain. Hernia. 2010;14:63–9. PubMedCrossRef
12.
Zurück zum Zitat Chisholm J, Dean NR. Massive paraumbilical hernia: not all is as it seems. Hernia. 2011;15:333–7. doi:1007/s10029–010-0645-4. PubMedCrossRef Chisholm J, Dean NR. Massive paraumbilical hernia: not all is as it seems. Hernia. 2011;15:333–7. doi:1007/s10029–010-0645-4. PubMedCrossRef
13.
Zurück zum Zitat An G, West MA. Abdominal compartment syndrome: a concise clinical review. Crit Care Med. 2008;36:1304–10. PubMedCrossRef An G, West MA. Abdominal compartment syndrome: a concise clinical review. Crit Care Med. 2008;36:1304–10. PubMedCrossRef
14.
Zurück zum Zitat Milev B, Mirkovic D, Bezmarevic M, et al. Intra-abdominal hypertension and abdominal compartment syndrome. Vojnosanit Pregl. 2010;67(8):674–80. PubMedCrossRef Milev B, Mirkovic D, Bezmarevic M, et al. Intra-abdominal hypertension and abdominal compartment syndrome. Vojnosanit Pregl. 2010;67(8):674–80. PubMedCrossRef
15.
Zurück zum Zitat Hunter JD. Abdominal compartment syndrome: an underdiagnosed contributory factor to morbidity and mortality in the critically ill. Postgrad Med J. 2008;84:293–8. PubMedCrossRef Hunter JD. Abdominal compartment syndrome: an underdiagnosed contributory factor to morbidity and mortality in the critically ill. Postgrad Med J. 2008;84:293–8. PubMedCrossRef
16.
Zurück zum Zitat Schachtrupp A, Hoer J, Tons C, et al. Intra-abdominal pressure: a reliable criterion for laparostomy closure? Hernia. 2002;6:102–7. Schachtrupp A, Hoer J, Tons C, et al. Intra-abdominal pressure: a reliable criterion for laparostomy closure? Hernia. 2002;6:102–7.
17.
Zurück zum Zitat English W. Abdominal compartment syndrome. World Federation of Societies of Anaesthesiologists (Internet). 2008. (cited 2008 Nov 30). Available from: http://​totw.​anaesthesiologis​ts.​org/​2008/​11/​30/​amdominal-compartment-syndrome-120/​.​ English W. Abdominal compartment syndrome. World Federation of Societies of Anaesthesiologists (Internet). 2008. (cited 2008 Nov 30). Available from: http://​totw.​anaesthesiologis​ts.​org/​2008/​11/​30/​amdominal-compartment-syndrome-120/​.​
18.
Zurück zum Zitat Cheatham ML, Safcsak K. Intraabdominal pressure: a revised method for measurement. J Am Coll Surg. 1998;186:594–5. PubMedCrossRef Cheatham ML, Safcsak K. Intraabdominal pressure: a revised method for measurement. J Am Coll Surg. 1998;186:594–5. PubMedCrossRef
19.
20.
Zurück zum Zitat Koontz AR. Hernias that have forfeited the right of domicile: use of pneumoperitoneum as an aid in their operative cure. South Med J. 1958;51:165–8. PubMedCrossRef Koontz AR. Hernias that have forfeited the right of domicile: use of pneumoperitoneum as an aid in their operative cure. South Med J. 1958;51:165–8. PubMedCrossRef
21.
Zurück zum Zitat Raynor RW, Del Guercio LR. The place for pneumoperitoneum in the repair of massive hernia. World J Surg. 1989;13(5):581–5. PubMedCrossRef Raynor RW, Del Guercio LR. The place for pneumoperitoneum in the repair of massive hernia. World J Surg. 1989;13(5):581–5. PubMedCrossRef
22.
Zurück zum Zitat Mayagoitia JC, Suarez D, Arenas JC, Diaz de Leon V. Preoperative progressive pneumoperitoneum in patients with abdominal-wall hernias. Hernia. 2006;10(3):213–7. PubMedCrossRef Mayagoitia JC, Suarez D, Arenas JC, Diaz de Leon V. Preoperative progressive pneumoperitoneum in patients with abdominal-wall hernias. Hernia. 2006;10(3):213–7. PubMedCrossRef
23.
Zurück zum Zitat Mathes SJ, Steinwald PM, Foster RD, Hoffman WY, Anthony JP. Complex abdominal wall reconstruction: a comparison of flap and mesh closure. Ann Surg. 2000;232(4):586–96. PubMedCrossRef Mathes SJ, Steinwald PM, Foster RD, Hoffman WY, Anthony JP. Complex abdominal wall reconstruction: a comparison of flap and mesh closure. Ann Surg. 2000;232(4):586–96. PubMedCrossRef
24.
25.
Zurück zum Zitat Ammar SA. Management of giant ventral hernia by polypropylene mash and host tissue barrier: trial of simplification. J Clin Med Res. 2009;1(4):226–9. PubMed Ammar SA. Management of giant ventral hernia by polypropylene mash and host tissue barrier: trial of simplification. J Clin Med Res. 2009;1(4):226–9. PubMed
26.
Zurück zum Zitat Ramirez OM, Ruas E, Dellon AL. Component separation method for closure of abdominal wall defects: an anatomic and clinic study. Plast Reconstr Surg. 1990;86:519–426. PubMedCrossRef Ramirez OM, Ruas E, Dellon AL. Component separation method for closure of abdominal wall defects: an anatomic and clinic study. Plast Reconstr Surg. 1990;86:519–426. PubMedCrossRef
27.
Zurück zum Zitat Crovella F, Bartone G, Fei L. Incisional hernia. In: Corso V, Bartolucci E, Todaro M, Veneroni L, Francioni G, editors. Abdominal compartment syndrome: clinical and physiopathologic implications in giant ventral hernias. Milano: Springer; 2008. pp. 47–56. Crovella F, Bartone G, Fei L. Incisional hernia. In: Corso V, Bartolucci E, Todaro M, Veneroni L, Francioni G, editors. Abdominal compartment syndrome: clinical and physiopathologic implications in giant ventral hernias. Milano: Springer; 2008. pp. 47–56.
28.
Zurück zum Zitat Munegato G, Grigoletto R, Brandolese R. Respiratory mechanics in abdominal compartment syndrome and large incisional hernias of the abdominal wall. Hernia. 2000;4:282–5. CrossRef Munegato G, Grigoletto R, Brandolese R. Respiratory mechanics in abdominal compartment syndrome and large incisional hernias of the abdominal wall. Hernia. 2000;4:282–5. CrossRef
29.
Zurück zum Zitat Crovella F, Bartone G, Fei L. Incisional hernia. In: Munegato G, Schiano di Visconte M, Ros DD, Sanna A, editors. Respiratory physiopathology in surgical repair of large abdominal hernias. Milano: Springer; 2008. pp. 57–72. Crovella F, Bartone G, Fei L. Incisional hernia. In: Munegato G, Schiano di Visconte M, Ros DD, Sanna A, editors. Respiratory physiopathology in surgical repair of large abdominal hernias. Milano: Springer; 2008. pp. 57–72.
30.
Zurück zum Zitat Cheatham ML. Nonoperative management of intraabdominal hypertension and abdominal compartment syndrome. World J Surg. 2009;33(6):1116–22. PubMedCrossRef Cheatham ML. Nonoperative management of intraabdominal hypertension and abdominal compartment syndrome. World J Surg. 2009;33(6):1116–22. PubMedCrossRef
31.
Zurück zum Zitat Parra JA, Revuelta S, Gallego T, Bueno J, Berrio JI, Farinas MC. Prosthetic mesh used for inguinal and ventral hernia repair: normal appearance and complications in ultrasound and CT. Br J Radiol. 2004;77:261–5. PubMedCrossRef Parra JA, Revuelta S, Gallego T, Bueno J, Berrio JI, Farinas MC. Prosthetic mesh used for inguinal and ventral hernia repair: normal appearance and complications in ultrasound and CT. Br J Radiol. 2004;77:261–5. PubMedCrossRef
32.
Zurück zum Zitat Chang EI, Foster RD, Hansen SL, Jazayeri L, Patti M. Autologous tissue reconstruction of ventral hernias in morbidly obese patients. Arch Surg. 2007;142:746–51. PubMedCrossRef Chang EI, Foster RD, Hansen SL, Jazayeri L, Patti M. Autologous tissue reconstruction of ventral hernias in morbidly obese patients. Arch Surg. 2007;142:746–51. PubMedCrossRef
33.
Zurück zum Zitat Bingener J, Buck L, Richards M, Michalek J, Schwesinger W, Sirinek K. Long-term outcomes in laparoscopic vs open ventral hernia repair. Arch Surg. 2007;142:562–7. PubMedCrossRef Bingener J, Buck L, Richards M, Michalek J, Schwesinger W, Sirinek K. Long-term outcomes in laparoscopic vs open ventral hernia repair. Arch Surg. 2007;142:562–7. PubMedCrossRef
34.
Zurück zum Zitat Novitsky Y, Cobb W, Kercher K, Matthews B, Sing R, Heniford T. Laparoscopic ventral hernia repair in obese patient. Arch Surg. 2006;141(1):57–61. PubMedCrossRef Novitsky Y, Cobb W, Kercher K, Matthews B, Sing R, Heniford T. Laparoscopic ventral hernia repair in obese patient. Arch Surg. 2006;141(1):57–61. PubMedCrossRef
35.
36.
Zurück zum Zitat Lambert DM, Marceau S, Forse RA. Intra-abdominal pressure in the morbidly obese. Obes Surg. 2005;15(9):1225–32. PubMedCrossRef Lambert DM, Marceau S, Forse RA. Intra-abdominal pressure in the morbidly obese. Obes Surg. 2005;15(9):1225–32. PubMedCrossRef
37.
Zurück zum Zitat Leppaniemi A. Surgical management of abdominal compartment syndrome; indications and techniques. Scand J Trauma Resusc Emerg Med. 2009;17:17. doi:10.1186/1757-7241-17-17. PubMedCrossRef Leppaniemi A. Surgical management of abdominal compartment syndrome; indications and techniques. Scand J Trauma Resusc Emerg Med. 2009;17:17. doi:10.1186/1757-7241-17-17. PubMedCrossRef
Metadaten
Titel
Conservative treatment of abdominal compartment syndrome after large ventral hernia repair
verfasst von
MD M. Bezmarevic
MD D. Slavkovic
MD, PhD B. Trifunovic
MD, PhD N. Stankovic
MD S. Mickovic
MD B. Neskovic
MD J. Beloica
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