title: Brain death due to abdominal compartment syndrome caused by massive venous bleeding in a patient with a stable pelvic fracture: report of a case.
abstract: We report a rare case in which abdominal compartment syndrome resulting from venous hemorrhaging developed in a patient with stable pelvic fractures, resulting in a fatal outcome. An 84-year-old man with mild pelvic fractures developed hypovolemic shock and underwent transcatheter arterial embolization. He became hemodynamically stable after the procedure, but became hypotensive for the second time 11 h after admission. Urinary bladder pressure rose to 32 mmHg from 4-7 mmHg. Rebleeding from the pelvis with the development of abdominal compartment syndrome was suspected. Repeated transcatheter arterial embolization and laparotomy were performed; however, 1 min into the procedure, both pupils symmetrically dilated and the light reflex disappeared. This case suggests that brain death can sometimes occur due to abdominal compartment syndrome.
authors.affiliation: Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Hagiwara
authors.forename: Hideki
authors.initials: H
authors.lastname: Fukushima
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Inoue
authors.forename: Atsuo
authors.initials: A
authors.lastname: Murata
authors.forename: Shuji
authors.initials: S
authors.lastname: Shimazaki
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D001926:Brain Death; D003161:Compartment Syndromes / Q000150:complications* / Q000209:etiology; D017809:Fatal Outcome; D050723:Fractures, Bone / Q000150:complications*; D006470:Hemorrhage / Q000150:complications* / Q000209:etiology; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D012187:Retroperitoneal Space