Cooper CE, Kennedy AP, Smith DP. Abdominal Compartment Syndrome in a Pediatric Patient With Cloacal Exstrophy.
Urology 2016;
93:185-7. [PMID:
26921644 DOI:
10.1016/j.urology.2016.02.025]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 01/31/2016] [Accepted: 02/16/2016] [Indexed: 11/17/2022]
Abstract
We present a rare complication of abdominal compartment syndrome (ACS) in a child undergoing complex urologic reconstruction. A 10-year-old female born with the abdominal wall defect cloacal exstrophy who had previously undergone multiple abdominal procedures then developed findings consistent with ACS following a complex Mitrofanoff procedure. Although intravesical pressures were not documented because of the nature of her reconstruction, her ACS-type findings were (1) abdominal pain, (2) melena, (3) pulmonary hypoinflation, (4) renal insufficiency, (5) tachycardia, and (6) segmental ischemic small bowel. Management consisted of abdominal decompression, segmental bowel resections, and wound vacuum-assisted-closure management. Patient was eventually discharged home.
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