New England Surgical Society (NESS)
Search NESS
  Annual Meeting
  Annual Resident and Fellow Research Day
      Member Directory
      Members Only
  Scholars Foundation
  Job Board
  Journal of the American College of Surgeons
  Contact NESS

NESS 2006 Annual Meeting
Back to Scientific Program
Back to Annual Meeting

Minimally Invasive Management of the Abdominal Compartment Syndrome: Initial Experience at a Level I Trauma Center
Forrest Fernandez, Vicente Cortes, Robert Brautigam, George Perdrizet
University of Connecticut/Hartford Hospital, Hartofrd, CT

Objective Determine if patients who develop abdominal compartment syndrome (ACS), while being managed non-operatively for blunt thoraco-abdominall trauma, could be treated with percutaneous ultrasound-guided abdominal paracentesis (PUP) and avoid decompressive ceilotomy. Previous animal work demonstrated effective reduction in ACS by small volume paracentesis, prompting our pilot clinical study.
Design/Setting/Patients A retrospective chart review of seven sequential adult patients admitted to a Level I Trauma Center at a university affiliated hospital for nonoperative management of severe blunt thoraco-abdominal trauma with IRB approval.
Intervention All patients had abdominal ultrasound-guided location of intra-peritoneal fluid then had percutaneous aspiration suing a 14-16Ga catheter.
Outcome Reduction in intra-abdominal compartment pressure and resolution of the ACS. Complications associated with PUP.
Results: Seven sequential cases of ACS treated by PUP over a 2 year period. All patients had resolution of clinical manifestations of ACS for which decompression was deemed necessary following PUP procedure (7/7). One patient expired secondary to a malignant cardiac arrhythmia and two died of traumatic brain injuries. Survival for the series was 57% (4/7).
Conclusion: PUP represents a safe, rapid, and efficacious alternative to DC in selected patients with ACS secondary to blunt thoraco-abdominal trauma.

Back to Scientific Program
Back to Annual Meeting

Copyright © 2020 New England Surgical Society. All Rights Reserved.
Read Privacy Policy.