title: Secondary abdominal compartment syndrome after complicated traumatic lower extremity vascular injuries.
abstract: BACKGROUND
  Secondary abdominal compartment syndrome (ACS) can occur in trauma patients without abdominal injuries. Surgical management of patients presenting with secondary ACS after isolated traumatic lower extremity vascular injury (LEVI) continues to evolve, and associated outcomes remain unknown.
  
  
  METHODS
  From January 2006 to September 2011, 191 adult trauma patients presented to the Ryder Trauma Center, an urban level I trauma center in Miami, Florida with traumatic LEVIs. Among them 10 (5.2 %) patients were diagnosed with secondary ACS. Variables collected included age, gender, mechanism of injury, and clinical status at presentation. Surgical data included vessel injury, technical aspects of repair, associated complications, and outcomes.
  
  
  RESULTS
  Mean age was 37.4 ± 18.0 years (range 16-66 years), and the majority of patients were males (8 patients, 80 %). There were 7 (70 %) penetrating injuries (5 gunshot wounds and 2 stab wounds), and 3 blunt injuries with mean Injury Severity Score (ISS) 21.9 ± 14.3 (range 9-50). Surgical management of LEVIs included ligation (4 patients, 40 %), primary repair (1 patient, 10 %), reverse saphenous vein graft (2 patients, 20 %), and PTFE interposition grafting (3 patients, 30 %). The overall mortality rate in this series was 60 %.
  
  
  CONCLUSIONS
  The association between secondary ACS and lower extremity vascular injuries carries high morbidity and mortality rates. Further research efforts should focus at identifying parameters to accurately determine resuscitation goals, and therefore, prevent such a devastating condition.
authors.affiliation: Providence Hospital and Medical Centers, 16001 W 9 Mile Rd, Southfield, MI, 48075, USA. igormacedo1@hotmail.com.
authors.forename: F I B
authors.initials: FI
authors.lastname: Macedo
authors.affiliation: Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center/Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Sciarretta
authors.affiliation: Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center/Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Otero
authors.affiliation: Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center/Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: G
authors.initials: G
authors.lastname: Ruiz
authors.affiliation: Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center/Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Ebler
authors.affiliation: Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center/Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Pizano
authors.affiliation: Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center/Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: N
authors.initials: N
authors.lastname: Namias
mesh_terms: D000328:Adult; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D015601:Injury Severity Score; D059325:Intra-Abdominal Hypertension / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D035002:Lower Extremity / Q000098:blood supply / Q000293:injuries; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D014193:Trauma Centers / Q000706:statistics & numerical data; D014656:Vascular Surgical Procedures / Q000379:methods; D057772:Vascular System Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D014950:Wounds, Penetrating / Q000150:complications / Q000175:diagnosis / Q000601:surgery
keywords: Abdominal compartment syndrome; Blunt; Lower extremity trauma; Penetrating; Vascular injury