Hidden Morbidity - Abdominal Compartment Syndrome
A 58 year old man with severe lumbar stenosis underwent anterior lumbar fusion complicated by injury to the left common iliac vein. 3.5 liters of blood was lost requiring large resuscitation. Continued instability prompted large volume crystalloid administration. Abdominal distension worsened presumably due to iatrogenic fluid overload. Despite bladder pressures measuring over 30 mmHg, urine output paradoxically remained adequate. Increased work of breathing presented late rendering organ dysfunction a delayed finding. He underwent decompression where two liters of blood was evacuated revealing unrecognized hemorrhage as abdominal compartment syndrome’s etiology. This case examines an ambiguous presentation of abdominal compartment syndrome.
Khan H, Nowatzke RW, Soto RG. Hidden morbidity - abdominal compartment syndrome. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/5690