The detrimental effects of intra-abdominal hypertension and
abdominal compartment syndrome (ACS) affect almost every system by altering
organ perfusion. Intra-abdominal hypertension, in which pressure is 12 to 20
mmHg whereas ACS, in which pressure is higher than 20 mmHg. Acute coronary
syndrome (ACS) is life threatening and is not very uncommon in our practice.
There is a clinical scenario of 70 year male with a history of absolute
constipation and abdominal distention with pain in the abdomen. He was attended
at Govt. hospital ER and was diagnosed with volvulus sigmoid colon and
immediate laparotomy with untwist of gut and sigmodopexy done. Closure of
abdomen was done without any abdominal drain tube and the patient was attempted
for extubation but did not achieve adequate % SpO2 and shifted to
ICU in intubated state. Following the night of the operation, the patient’s
abdomen was becoming tense and diagnosed with ACS and immediate Flatus tube and
NG tube were inserted. Both tubes were kept in situ for>48 hours and the
patient’s abdomen became soft and normal. This paper describes the management
of the ACS, and all measures presented (NGT, flatus tube, TPN, intravenous
therapy, ventilator support, etc) in combination may have produced the
desirable effect for this particular patient, even if seemingly NGT and flatus
tube had a decisive action.
Author(s)details:-
Chishti Tanhar Bakth
Choudhury
Department of Surgery, Northern International Medical College Hospital
(NIMCH), Bangladesh.
Md. Golam Afsar
NIMCH, Bangladesh.
Mahmudur Rahman
Khandoker
Department of Anaesthesia, Intensive Care and Pain Medicine NIMCH,
Bangladesh.
Please See the book
here :- https://doi.org/10.9734/bpi/mria/v4/8580E
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