Intra-abdominal hypertension and abdominal compartment syndrome in pediatrics. A review

Thabet, Farah; Ejike, J. Chiaka

doi:10.1016/j.jcrc.2017.06.004

Cited by 45 publications

(49 citation statements)

References 70 publications

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“…Neonatal resuscitation would have also led to reperfusion injury and its consequent inflammatory response. Such would have aggravated body fluid shifts, which would then have further increased intraabdominal pressures [17].…”

Section: Discussionmentioning

confidence: 99%

“…Elevated intra-abdominal pressure, or intra-abdominal hypertension (IAH) can occur in several clinical scenarios -diminished abdominal wall compliance, increased intra-abdominal or intra-luminal contents, interstitial fluid accumulation, and others [17]. The increased abdominal pressure can lead to local effects, such as visceral hypoperfusion and its consequences (e.g., the anuria observed in the present case), as well as more systemic sequela, including further tissue damage brought about by hypoxemia from impaired ventilation [18].…”

Section: Discussionmentioning

confidence: 99%

“…The cut-off values are lower for children for both measures, at 10 mmHg [19]. The monitoring of intra-vesical pressures (IVP) as a proxy measure of intra-abdominal pressures has been recommended [17,19]. Nonetheless, there are limitations with this approach, and thresholds are yet to be set for neonates [20].…”

Section: Discussionmentioning

confidence: 99%

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Hydrops fetalis and neonatal abdominal compartment syndrome continuum from immature gastric teratoma: a case report

Caballes

Dungca

et al. 2020

BMC Pediatr

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Background: Hydrops fetalis as well as abdominal compartment syndrome (ACS) are conditions that are associated with high mortality rates. A rare case of immature gastric teratoma causing fetal hydrops and subsequent ACS is presented. The related pathophysiologic mechanisms are discussed, and the importance of timely recognition and appropriate interventions are highlighted. Case presentation: The male patient was born preterm, weighing 3.9 kg., by Cesarean section. Prior prenatal ultrasounds were normal, but a scan done just before delivery had findings indicating polyhydramnios, fetal ascites, and meconium peritonitis. Upon delivery, the patient had respiratory distress, anasarca and a massively distended abdomen. Resuscitation measures, including ventilatory support, were instituted. Imaging studies showed ascites as well as a large, complex intra-abdominal lesion with calcifications. In the succeeding hours, anuria persisted, anasarca worsened, the abdomen became more distended, and inotrope requirements increased. The occurrence of ACS, from what was presumed to be a retroperitoneal teratoma, was therefore considered. Laparotomy was done on the 28th hour of life, with en bloc excision of a massive tumor and attached section of the greater curvature of the stomach. Passage of urine occurred intra-operatively, and the patient was soon after weaned off inotropes and ventilator support. The histopathologic result was immature gastric teratoma. No chemotherapy was given, and the patient's serum AFP is at normal levels 15 months following surgery. Conclusion: The presence of a massive intra-abdominal lesion can result in the pathophysiologic continuum of hydrops fetalis and neonatal ACS. The early recognition of such an association can enable appropriate expectant management of similarly affected neonates, including emergent decompression laparotomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hydrops fetalis and neonatal abdominal compartment syndrome continuum from immature gastric teratoma: a case report

Caballes

Dungca

et al. 2020

BMC Pediatr

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“…Thus the consequent bacterial shift into the bloodstream causes bacteremia, systemic inflammatory response and hemodynamic instability. The purpose of management of critical pediatric patients is to avoid ACS progression and the development of multi-organ dysfunction syndrome [14].…”

Section: Complicationsmentioning

confidence: 99%

Pediatric Pancreatitis: Not a Rare Entity

Valabrega¹,

Bersigotti²,

Antolino³

et al. 2019

Pancreatitis

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The incidence of acute pancreatitis is increasing in children and it should be considered as part of differential diagnosis in case of abdominal pain. The etiology of acute pancreatitis in this subpopulation is related to several conditions and risk factors, such as drugs, obesity, infections, trauma and anatomic abnormalities. In older children abdominal pain is the first symptom in more than 90% of cases, where as in younger children vomiting represents an early clinical manifestation. Diagnosis is based on laboratory investigation, such as serum levels of lipase, and imaging findings (ultrasonography, CT scanning or MRI) such as detecting edema, hemorrage or necrosis of pancreatic parenchyma or in peripancreatic fat. Treatments for adults and children are similar. Rapid and accurate assessment of the severity of pancreatitis is absolutely indicated for selecting the appropriate treatment and predicting the prognosis.

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“…ACS is not rare and has a high mortality in the paediatric intensive care unit; the incidence and mortality rate are 0.6%–4.7% and 16%–86%, respectively 2. Although physicians should recognise and intervene rapidly in paediatric ACS cases, previous reports revealed that awareness of it was not sufficient 3 4.…”

Section: Introductionmentioning

confidence: 99%

Paediatric abdominal compartment syndrome and shock associated with gastric volvulus improved rapidly by gastric suction in the emergency department

Tetsuhara¹,

Tsuji

Tomonaga

2019

BMJ Case Rep

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Abdominal compartment syndrome (ACS) is not rare and has a high mortality in the paediatric intensive care unit. However, there are few reports about this in the emergency department (ED). We report an 8 month-old male patient with ACS in shock associated with gastric volvulus who improved rapidly by a simple procedure in the ED. He had congenital comorbidities, including multiple cranial anomalies and was transferred because of decreased mental status. He had compensated shock with cold and mottled skin of the lower extremities, paediatric Glasgow Coma Scale of E3V5M6 and prominence of the left upper abdomen. The abdominal X-ray showed a considerably distended stomach. Soon after aspiration of gastric contents, shock and mental status improved. Physicians should consider ACS in the differential diagnosis of shock with abdominal distention. ACS may be ameliorated by gastric suction. Gastric volvulus can induce shock and decreased mental status, particularly in patients with comorbidities.

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Intra-abdominal hypertension and abdominal compartment syndrome in pediatrics. A review

Cited by 45 publications

References 70 publications

Hydrops fetalis and neonatal abdominal compartment syndrome continuum from immature gastric teratoma: a case report

Hydrops fetalis and neonatal abdominal compartment syndrome continuum from immature gastric teratoma: a case report

Pediatric Pancreatitis: Not a Rare Entity

Paediatric abdominal compartment syndrome and shock associated with gastric volvulus improved rapidly by gastric suction in the emergency department

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