Skip to main content
Top
Published in: Hernia 2/2015

01-04-2015 | Review

Abdominal compartment syndrome as a rare complication following component separation repair: case report and review of the literature

Authors: H. S. Oliver-Allen, C. Hunter, G. K. Lee

Published in: Hernia | Issue 2/2015

Login to get access

Abstract

One of the most feared complications following a massive ventral hernia repair is abdominal compartment syndrome (ACS). ACS is caused by an acute increase in intra-abdominal pressure (IAP), which can lead to multi-organ dysfunction and ultimately result in death. Component separation repair (CST) has been successful for most large hernia repairs in reducing the risk of ACS by increasing abdominal volume and reducing abdominal wall tension during a tight closure. However, reduction of a large hernia can lead to elevated IAP and possible progression to ACS. Here, we describe the detailed intra-operative and post-operative course of a patient who developed abdominal compartment syndrome following CST repair.
Literature
1.
go back to reference Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72:70–71CrossRefPubMed Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72:70–71CrossRefPubMed
2.
go back to reference Santora TA, Roslyn JJ (1993) Incisional hernia. Surg Clin North Am 73:557–570PubMed Santora TA, Roslyn JJ (1993) Incisional hernia. Surg Clin North Am 73:557–570PubMed
3.
go back to reference George CD, Ellis H (1986) The results of incisional hernia repair: a twelve year review. Ann R Coll Surg Engl 68:185–187PubMedCentralPubMed George CD, Ellis H (1986) The results of incisional hernia repair: a twelve year review. Ann R Coll Surg Engl 68:185–187PubMedCentralPubMed
4.
go back to reference Vargo D (2004) Component separation in the management of the difficult abdominal wall. Am J Surg 188:633–637CrossRefPubMed Vargo D (2004) Component separation in the management of the difficult abdominal wall. Am J Surg 188:633–637CrossRefPubMed
5.
go back to reference De vries reilingh TS, Bodegom ME, Van goor H et al (2007) Autologous tissue repair of large abdominal wall defects. Br J Surg 94:791–803CrossRefPubMed De vries reilingh TS, Bodegom ME, Van goor H et al (2007) Autologous tissue repair of large abdominal wall defects. Br J Surg 94:791–803CrossRefPubMed
6.
go back to reference De vries reilingh TS, Van goor H, Rosman C et al (2003) “Components separation technique” for the repair of large abdominal wall hernias. J Am Coll Surg 196:32–37CrossRefPubMed De vries reilingh TS, Van goor H, Rosman C et al (2003) “Components separation technique” for the repair of large abdominal wall hernias. J Am Coll Surg 196:32–37CrossRefPubMed
7.
go back to reference Moore M, Bax T, Macfarlane M, Mcnevin MS (2008) Outcomes of the fascial component separation technique with synthetic mesh reinforcement for repair of complex ventral incisional hernias in the morbidly obese. Am J Surg 195:575–579CrossRefPubMed Moore M, Bax T, Macfarlane M, Mcnevin MS (2008) Outcomes of the fascial component separation technique with synthetic mesh reinforcement for repair of complex ventral incisional hernias in the morbidly obese. Am J Surg 195:575–579CrossRefPubMed
8.
go back to reference Ramirez OM, Ruas E, Dellon AL (1990) “Components separation” method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg 86:519–526CrossRefPubMed Ramirez OM, Ruas E, Dellon AL (1990) “Components separation” method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg 86:519–526CrossRefPubMed
9.
go back to reference Lowe JB, Lowe JB, Baty JD et al (2003) Risks associated with “components separation” for closure of complex abdominal wall defects. Plast Reconstr Surg 111:1276–1283CrossRefPubMed Lowe JB, Lowe JB, Baty JD et al (2003) Risks associated with “components separation” for closure of complex abdominal wall defects. Plast Reconstr Surg 111:1276–1283CrossRefPubMed
10.
go back to reference Saggi BH, Sugerman HJ, Ivatury RR et al (1998) Abdominal compartment syndrome. J Trauma 45:597–609CrossRefPubMed Saggi BH, Sugerman HJ, Ivatury RR et al (1998) Abdominal compartment syndrome. J Trauma 45:597–609CrossRefPubMed
11.
go back to reference Kirkpatrick AW, Roberts DJ, De waele J et al (2013) Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med 39:1190–1206CrossRefPubMedCentralPubMed Kirkpatrick AW, Roberts DJ, De waele J et al (2013) Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med 39:1190–1206CrossRefPubMedCentralPubMed
12.
go back to reference Cheatham ML, Malbrain ML, Kirkpatrick A et al (2007) Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. II. Recommendations. Intensive Care Med 33:951–962CrossRefPubMed Cheatham ML, Malbrain ML, Kirkpatrick A et al (2007) Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. II. Recommendations. Intensive Care Med 33:951–962CrossRefPubMed
13.
go back to reference De cleva R, Silva FP, Zilberstein B et al (2001) Acute renal failure due to abdominal compartment syndrome: report on four cases and literature review. Rev Hosp Clin Fac Med Sao Paulo 56:123–130CrossRefPubMed De cleva R, Silva FP, Zilberstein B et al (2001) Acute renal failure due to abdominal compartment syndrome: report on four cases and literature review. Rev Hosp Clin Fac Med Sao Paulo 56:123–130CrossRefPubMed
14.
go back to reference Adekunle S, Pantelides NM, Hall NR et al (2013) Indications and outcomes of the components separation technique in the repair of complex abdominal wall hernias: experience from the cambridge plastic surgery department. Eplasty 13:388–396 Adekunle S, Pantelides NM, Hall NR et al (2013) Indications and outcomes of the components separation technique in the repair of complex abdominal wall hernias: experience from the cambridge plastic surgery department. Eplasty 13:388–396
15.
go back to reference Agnew SP, Small W, Wang E et al (2010) Prospective measurements of intra-abdominal volume and pulmonary function after repair of massive ventral hernias with the components separation technique. Ann Surg 251:981–988CrossRefPubMed Agnew SP, Small W, Wang E et al (2010) Prospective measurements of intra-abdominal volume and pulmonary function after repair of massive ventral hernias with the components separation technique. Ann Surg 251:981–988CrossRefPubMed
16.
go back to reference Mavrodin CI, Pariza G, Ion D et al (2013) Abdominal compartment syndrome—a major complication of large incisional hernia surgery. Chirurgia (Bucur) 108:414–417 Mavrodin CI, Pariza G, Ion D et al (2013) Abdominal compartment syndrome—a major complication of large incisional hernia surgery. Chirurgia (Bucur) 108:414–417
17.
go back to reference Malbrain ML, Cheatham ML, Kirkpatrick A et al (2006) Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions. Intensive Care Med 32:1722–1732CrossRefPubMed Malbrain ML, Cheatham ML, Kirkpatrick A et al (2006) Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions. Intensive Care Med 32:1722–1732CrossRefPubMed
18.
go back to reference Dubay DA, Choi W, Urbanchek MG et al (2007) Incisional herniation induces decreased abdominal wall compliance via oblique muscle atrophy and fibrosis. Ann Surg 245:140–146CrossRefPubMedCentralPubMed Dubay DA, Choi W, Urbanchek MG et al (2007) Incisional herniation induces decreased abdominal wall compliance via oblique muscle atrophy and fibrosis. Ann Surg 245:140–146CrossRefPubMedCentralPubMed
19.
go back to reference Hadad I, Small W, Dumanian GA (2009) Repair of massive ventral hernias with the separation of parts technique: reversal of the ‘lost domain’. Am Surg 75:301–306PubMed Hadad I, Small W, Dumanian GA (2009) Repair of massive ventral hernias with the separation of parts technique: reversal of the ‘lost domain’. Am Surg 75:301–306PubMed
20.
21.
go back to reference Coombs HC (1920) The mechanism of the regulation of intra-abdominal pressures. Am J Physiol 61:159–163 Coombs HC (1920) The mechanism of the regulation of intra-abdominal pressures. Am J Physiol 61:159–163
22.
23.
go back to reference Fietsam R, Villalba M, Glover JL et al (1989) Intra-abdominal compartment syndrome as a complication of ruptured abdominal aortic aneurysm repair. Am Surg 55:396–402PubMed Fietsam R, Villalba M, Glover JL et al (1989) Intra-abdominal compartment syndrome as a complication of ruptured abdominal aortic aneurysm repair. Am Surg 55:396–402PubMed
24.
go back to reference Sanchez NC, Tenofsky PL, Dort JM et al (2001) What is normal intra-abdominal pressure? Am Surg 67:243–248PubMed Sanchez NC, Tenofsky PL, Dort JM et al (2001) What is normal intra-abdominal pressure? Am Surg 67:243–248PubMed
25.
go back to reference Sugerman H, Windsor A, Bessos M et al (1997) Intra-abdominal pressure, sagittal abdominal diameter and obesity comorbidity. J Intern Med 241:71–79CrossRefPubMed Sugerman H, Windsor A, Bessos M et al (1997) Intra-abdominal pressure, sagittal abdominal diameter and obesity comorbidity. J Intern Med 241:71–79CrossRefPubMed
26.
go back to reference Papavramidis TS, Marinis AD, Pliakos I et al (2011) Abdominal compartment syndrome—intra-abdominal hypertension: defining, diagnosing, and managing. J Emerg Trauma Shock 4:279–291CrossRefPubMedCentralPubMed Papavramidis TS, Marinis AD, Pliakos I et al (2011) Abdominal compartment syndrome—intra-abdominal hypertension: defining, diagnosing, and managing. J Emerg Trauma Shock 4:279–291CrossRefPubMedCentralPubMed
27.
go back to reference Cheatham ML, White MW, Sagraves SG, Johnson JL, Block EF (2000) Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension. J Trauma 49:621–626CrossRefPubMed Cheatham ML, White MW, Sagraves SG, Johnson JL, Block EF (2000) Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension. J Trauma 49:621–626CrossRefPubMed
28.
go back to reference Diebel LN, Dulchavsky SA, Wilson RF (1992) Effect of increased intra-abdominal pressure on mesenteric arterial and intestinal mucosal blood flow. J Trauma 33:45–48CrossRefPubMed Diebel LN, Dulchavsky SA, Wilson RF (1992) Effect of increased intra-abdominal pressure on mesenteric arterial and intestinal mucosal blood flow. J Trauma 33:45–48CrossRefPubMed
29.
go back to reference Diebel LN, Wilson RF, Dulchavsky SA et al (1992) Effect of increased intra-abdominal pressure on hepatic arterial, portal venous, and hepatic microcirculatory blood flow. J Trauma 33:279–282CrossRefPubMed Diebel LN, Wilson RF, Dulchavsky SA et al (1992) Effect of increased intra-abdominal pressure on hepatic arterial, portal venous, and hepatic microcirculatory blood flow. J Trauma 33:279–282CrossRefPubMed
30.
go back to reference Ivatury RR, Porter JM, Simon RJ et al (1998) Intra-abdominal hypertension after life-threatening penetrating abdominal trauma: prophylaxis, incidence, and clinical relevance to gastric mucosal pH and abdominal compartment syndrome. J Trauma 44:1016–1021CrossRefPubMed Ivatury RR, Porter JM, Simon RJ et al (1998) Intra-abdominal hypertension after life-threatening penetrating abdominal trauma: prophylaxis, incidence, and clinical relevance to gastric mucosal pH and abdominal compartment syndrome. J Trauma 44:1016–1021CrossRefPubMed
33.
go back to reference Burch JM, Moore EE, Moore FA et al (1996) The abdominal compartment syndrome. Surg Clin North Am 76:833–842CrossRefPubMed Burch JM, Moore EE, Moore FA et al (1996) The abdominal compartment syndrome. Surg Clin North Am 76:833–842CrossRefPubMed
34.
go back to reference Bloomfield GL, Dalton JM, Sugerman HJ et al (1995) Treatment of increasing intracranial pressure secondary to the acute abdominal compartment syndrome in a patient with combined abdominal and head trauma. J Trauma 39:1168–1170CrossRefPubMed Bloomfield GL, Dalton JM, Sugerman HJ et al (1995) Treatment of increasing intracranial pressure secondary to the acute abdominal compartment syndrome in a patient with combined abdominal and head trauma. J Trauma 39:1168–1170CrossRefPubMed
35.
go back to reference Iberti TJ, Kelly KM, Gentili DR et al (1987) A simple technique to accurately determine intra-abdominal pressure. Crit Care Med 15:1140–1142CrossRefPubMed Iberti TJ, Kelly KM, Gentili DR et al (1987) A simple technique to accurately determine intra-abdominal pressure. Crit Care Med 15:1140–1142CrossRefPubMed
36.
go back to reference Moreno IG (1947) Chronic eventrations and large hernias; preoperative treatment by progressive pneumoperitoneum; original procedure. Surgery. 22:945–953PubMed Moreno IG (1947) Chronic eventrations and large hernias; preoperative treatment by progressive pneumoperitoneum; original procedure. Surgery. 22:945–953PubMed
37.
go back to reference Willis S, Schumpelick V (2000) Use of progressive pneumoperitoneum in the repair of giant hernias. Hernia 4:105–111CrossRef Willis S, Schumpelick V (2000) Use of progressive pneumoperitoneum in the repair of giant hernias. Hernia 4:105–111CrossRef
38.
go back to reference Caldironi MW, Romano M, Bozza F et al (1990) Progressive pneumoperitoneum in the management of giant incisional hernias: a study of 41 patients. Br J Surg 77:306–307CrossRefPubMed Caldironi MW, Romano M, Bozza F et al (1990) Progressive pneumoperitoneum in the management of giant incisional hernias: a study of 41 patients. Br J Surg 77:306–307CrossRefPubMed
39.
go back to reference Sabbagh C, Dumont F, Fuks D, Yzet T, Verhaeghe P, Regimbeau JM (2012) Progressive preoperative pneumoperitoneum preparation (the Goni Moreno protocol) prior to large incisional hernia surgery: volumetric, respiratory and clinical impacts. A prospective study. Hernia 16:33–40CrossRefPubMed Sabbagh C, Dumont F, Fuks D, Yzet T, Verhaeghe P, Regimbeau JM (2012) Progressive preoperative pneumoperitoneum preparation (the Goni Moreno protocol) prior to large incisional hernia surgery: volumetric, respiratory and clinical impacts. A prospective study. Hernia 16:33–40CrossRefPubMed
40.
go back to reference Luckianow GM, Ellis M, Governale D et al (2012) Abdominal compartment syndrome: risk factors, diagnosis, and current therapy. Crit Care Res Pract. 2012:908169PubMedCentralPubMed Luckianow GM, Ellis M, Governale D et al (2012) Abdominal compartment syndrome: risk factors, diagnosis, and current therapy. Crit Care Res Pract. 2012:908169PubMedCentralPubMed
41.
go back to reference Chang MC, Miller PR, D’agostino R et al (1998) Effects of abdominal decompression on cardiopulmonary function and visceral perfusion in patients with intra-abdominal hypertension. J Trauma 44:440–445CrossRefPubMed Chang MC, Miller PR, D’agostino R et al (1998) Effects of abdominal decompression on cardiopulmonary function and visceral perfusion in patients with intra-abdominal hypertension. J Trauma 44:440–445CrossRefPubMed
Metadata
Title
Abdominal compartment syndrome as a rare complication following component separation repair: case report and review of the literature
Authors
H. S. Oliver-Allen
C. Hunter
G. K. Lee
Publication date
01-04-2015
Publisher
Springer Paris
Published in
Hernia / Issue 2/2015
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-015-1362-9

Other articles of this Issue 2/2015

Hernia 2/2015 Go to the issue