Abdominal Compartment Syndrome - a Surgical Emergency

Abstract

Over the past six decades, abdominal compartment syndrome (ACS) remained a very controversial subject, both in surgical and non-surgical specialties. Doctors failed to understand why critically ill patients died in the ICU with distended abdomens without fi nding any cause or why postoperative patients with wound defects such as dehiscence died after suturing the wound again "very tightly". After the concept of intra-abdominal pressure (IAP) was established and methods for measuring it and diagnosing intra-abdominal hypertension (IAH) were available for clinicians to use it, it became clearer that ACS was a very serious and life threating pathology and the need for a correct treatment is essential. In this article we will try to make a literature review of the past decade and see when and how to diagnose correctly a patient with ACS and also how the diagnostic and treatments methods changed over the years. RezumatÎn ultimele șase decenii, sindromul compartimentului abdominal a rămas un subiect foarte controversat, atât în specialităţile chirurgicale, cât și în cele non-chirurgicale. Medicii nu înţelegeau de ce pacienţii în stare critică decedau în ATI cu abdomenul destins, fără a găsi nicio cauză sau de ce pacienţii cu evisceraţii postoperatorii, decedau după resuturarea "foarte strânsă" a plăgii. După ce a fost stabilit conceptul de presiune intraabdominală și au fost disponibile metode pentru măsurarea și diagnosticarea hipertensiunii intra-abdominale pentru clinicieni, a devenit mai clar că sindromul de compartiment reprezintă o patologie foarte gravă, care ameninţă viaţa și că necesitatea unui tratament corect este esenţială. În acest articol vom încerca să facem o revizuire a literaturii ultimului deceniu și să vedem când și cum diagnosticăm corect un pacient cu sindrom de compartiment și, de asemenea, modul în care metodele de diagnosticare și tratament s-au schimbat de-a lungul anilor. Cuvinte cheie: sindrom de compartiment, presiune intra-abdominală crescută REVIEW Bogdan Socea et al.

Abdominal Compartment Syndrome—When Is Surgical Decompression Needed?

“…ACS was classified by the WSACS based on the underlying mechanism into primary ACS or ACS secondary to a pre-existing condition [ 10 , 15 ]. Primary ACS is a complication of injuries located in the abdomino-pelvic region, whereas secondary ACS occurs in the context of conditions that affect other regions of the body.…”

Iodoform (triiodomethane)- An Old, but Still Extremely Efficient Antiseptic

“…Iodoform or Triiodomethane is an iodine organic compound of the formula CHI 3 , with a tetrahedral molecular geometry, with a molecular weight of 393,732 g / mol, being a bright crystalline powder of bright, odorspecific, unpleasant, and persistent [6].…”

“…It is a substance very slightly soluble in water, but soluble in ethanol and methanol and has been extensively used in the past centuries (XIX th and XX th ) as a suppressant wound disinfectant, dermato-venereal disinfectant, antiseptic agent in dentistry, otorhinolaryngology and veterinary medicine [8]. It is used as crystalline powder coated in wounds or in the form of iodoform gauze dressings [6][7][8].…”

“…Its use was subsequently greatly limited due to its irritating qualities, the extremely strong smell, and the development of more effective disinfectants [6,8,10,11].…”

“…Currently, it is widely used only in dentistry (iodoform gauzes) and, as etheric solutions of concentrations of 2-3%, in veterinary medicine, especially in large or medium sized animals (equines, sheep, cattle, goats, swine, canines and birds) [6,8].…”