Acute renal failure due to abdominal compartment syndrome: report on four cases and literature review.
We report on 4 cases of abdominal compartment syndrome complicated by acute renal failure that were promptly reversed by different abdominal decompression methods. Case 1: A 57-year-old obese woman in the post-operative period after giant incisional hernia correction with an intra-abdominal pressure of 24 mm Hg. She was sedated and curarized, and the intra-abdominal pressure fell to 15 mm Hg. Case 2: A 73-year-old woman with acute inflammatory abdomen was undergoing exploratory laparotomy when a hypertensive pneumoperitoneum was noticed. During the surgery, enhancement of urinary output was observed. Case 3: An 18-year-old man who underwent hepatectomy and developed coagulopathy and hepatic bleeding that required abdominal packing, developed oliguria with a transvesical intra-abdominal pressure of 22 mm Hg. During reoperation, the compresses were removed with a prompt improvement in urinary flow. Case 4: A 46-year-old man with hepatic cirrhosis was admitted after incisional hernia repair with intra-abdominal pressure of 16 mm Hg. After paracentesis, the intra-abdominal pressure fell to 11 mm Hg.
de Cleva
R
R
Department of Gastroenterology (Surgical ICU), Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Brazil.
Silva
F P
FP
Zilberstein
B
B
Machado
D J
DJ
D000005:Abdomen / Q000503:physiopathology* / Q000601:surgery; D058186:Acute Kidney Injury / Q000209:etiology*; D000293:Adolescent; D000368:Aged; D003161:Compartment Syndromes / Q000150:complications* / Q000601:surgery; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged