Abdominal compartment syndrome after hip arthroscopy.
As hip arthroscopy becomes a more common procedure, more complications may occur. We present a case of abdominal compartment syndrome resulting from fluid extravasation in a 42-year-old man who underwent routine hip arthroscopy for femoral acetabular impingement. He had not had previous surgeries to that hip, and arthroscopy was performed in the supine position. After adequate distraction, arthroscopy was performed with an automated pressure- and flow-controlled pump with the pressure maintained between 40 and 60 mm Hg. We performed debridement of a degenerative tear of the anterosuperior labrum, removal of a pincer lesion, and a psoas tenotomy through a capsular window. A distended abdomen was noted on drape removal, and the patient required decompressive laparotomy for abdominal compartment syndrome. Extravasation of arthroscopy fluid is a potentially devastating complication during hip arthroscopy, and there should be careful monitoring by the surgeons, anesthesiologists, and operating room staff.
Fowler
Justin
J
Division of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA.
Owens
Brett D
BD
D034841:Abdominal Cavity; D000077:Acetabulum / Q000473:pathology; D000328:Adult; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000293:injuries / Q000473:pathology / Q000601:surgery; D003161:Compartment Syndromes / Q000209:etiology* / Q000601:surgery; D003646:Debridement / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005269:Femur / Q000473:pathology; D050724:Fractures, Cartilage / Q000601:surgery; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D007813:Laparotomy; D008297:Male; D008889:Military Personnel; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012187:Retroperitoneal Space; D013710:Tendons / Q000601:surgery; D007507:Therapeutic Irrigation / Q000009:adverse effects*