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Date Published: 31/10/2022
Abstract Views: 399
Views PDF: 286
DOI: https://doi.org/10.47972/vjcts.v39i.798
Issue
Vol. 39
Section
Research Article
How to Cite
Vinh, B. D. A., Tuan, L. Q. A., Thinh, V. H., Chuong, P. T. V. ., Thanh, N. V. T., Nam, N. H., & Dinh, N. H. (2022). Abdominal compartment syndrome after endovascular repair of ruptured abdominal aortic aneurysm: A case report and literature review. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 39, 7-17. https://doi.org/10.47972/vjcts.v39i.798

Abdominal compartment syndrome after endovascular repair of ruptured abdominal aortic aneurysm: A case report and literature review

Bui Duc An Vinh, Le Quan Anh Tuan, Vu Huu Thinh, Pham Tran Viet Chuong, Nguyen Van Thai Thanh, Nguyen Hoai Nam, Nguyen Hoang Dinh

Main Article Content

Abstract

Background: Abdominal compartment syndrome (ACS) arises in approximately 7% after ruptured abdominal aortic aneurysm (RAAA) treatment. Decompressive laparotomy is a satisfactory way to treat ACS. The problem is deciding when to complete abdominal closure with appropriate alternative treatments.[1]


Methods: This is a case report of successful ACS treatment following RAAA intervention at Ho Chi Minh University Hospital of Medicine and Pharmacy with a literature review.


Clinical case: A 61-year-old male patient was hospitalized for abdominal pain. Computed tomography angiography demonstrated RAAA. He underwent the emergency endovascular repair of ruptured aneurysms (rEVAR). At 30 minutes post-intervention, the patient's abdomen was distended following intraabdominal hypertension measured via bladder catheter. Within ACS diagnosing, emergency decompressive laparoscopy was performed. The abdominal wall was left open and covered with a sterile nylon cover. The fascial closure was performed on the sixth postoperative day with the support of vacuum-assisted wound closure (VAC) and mesh-mediated fascial traction. On the 27th postoperative day, the wound could close completely, and the patient could be discharged successfully.


Conclusion: A bladder pressure is required to monitor intraabdominal pressure postoperatively after decompressive laparotomy. Delayed fascial closure is appropriate with supporting VAC until total abdominal closure.

Article Details

Keywords

Abdominal Compartment Syndrome, Ruptured Abdominal Aortic Aneurysm, Decompressive Laparotomy, Total Abdominal Closure, Vacuum Assisted Wound Closure

References

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