Obstruction of vena cava and collateral flow after abdominal reconstruction for gastroschisis.
The upper limit of intra-abdominal pressure after closure of gastroschisis has been suggested around 20 mm Hg. An acute abdominal compartmental syndrome may produce intestinal ischemia with perforation and hepatic or renal failure. We present a case of a baby born with gastroschisis and ileal atresias 2 decades ago. The closure of the defect entailed a borderline abdominal compartmental syndrome with caval occlusion and development of collateral venous circulation. This was evidenced by a phlebographic study at the age of 8. At the age of 19, the patient continued to show a superficial, varicose net and some aesthetic concerns. This minor condition seems not previously reported. The authors intend to raise awareness about current methods for indirect assessment of intra-abdominal pressure when performing abdominal reconstruction for a gastroschisis defect.
Department of Plastic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; Department of Oncologic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; and Department of Radiology, Pediatric Hospital Coimbra, Coimbra, Portugal.
Wenceslao M
WM
Calonge
Department of Plastic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; Department of Oncologic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; and Department of Radiology, Pediatric Hospital Coimbra, Coimbra, Portugal.
Manuel R
MR
Ramos
Department of Plastic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; Department of Oncologic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; and Department of Radiology, Pediatric Hospital Coimbra, Coimbra, Portugal.
Paulo
P
Coelho
Department of Plastic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; Department of Oncologic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; and Department of Radiology, Pediatric Hospital Coimbra, Coimbra, Portugal.
Júlio R
JR
Alves
Department of Plastic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; Department of Oncologic Surgery, Pediatric Hospital Coimbra, Coimbra, Portugal; and Department of Radiology, Pediatric Hospital Coimbra, Coimbra, Portugal.
António
A
Ochoa de Castro