Abdominal Compartment Syndrome Causing Respiratory Failure During Surgery for a Ruptured Descending Thoracic Aneurysm : Report of a Case

• Published in: Surgery today (Tokyo, Japan) Vol. 35; no. 4; pp. 320 - 322
• Main Authors: Shiiya, Norihiko, Matsuzaki, Kenji, Miyatake, Tsukasa, Yoshimoto, Kimihiro, Yasuda, Keishu
• Format: Journal Article
• Language: English
• Published: Japan 01.04.2005
• Subjects: Abdomen; Abdominal compartment syndrome; Aneurysm, Ruptured - surgery; Aortic Aneurysm, Thoracic - surgery; Compartment Syndromes - complications; Deep hypothermic circulatory arrest; Heart Arrest, Induced; Humans; Hypothermia, Induced; Male; Middle Aged; Respiratory Insufficiency - etiology; Rupture; Thoracic aortic aneurysm
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-004-2923-1

Elevated intra-abdominal pressure causing widespread organ dysfunction is known as abdominal compartment syndrome (ACS). The subject of our case report is a 64-year-old man who underwent repair of a ruptured descending thoracic aortic aneurysm (TAA) under deep hypothermic circulatory arrest. During the operation, decompression laparotomy was required to relieve intra-abdominal hypertension causing respiratory failure, before the patient could be weaned off cardiopulmonary bypass. We report this case to alert surgeons to the fact that ACS can occur during surgery on the thoracic aorta, especially if massive fluid resuscitation is required and venous drainage for extracorporeal circulation is less than optimal. Early recognition and prompt decompression by laparotomy is essential to save the life of the patient.