Suspected abdominal compartment syndrome during endoscopic diskectomy - A case report -

Abstract

Incisions made in endoscopic operations are small, decreasing tissue damage and speeding recovery. Endoscopic techniques are therefore widely used in various surgeries, including knee and shoulder joint surgery and vertebral disc operations. However, it is necessary to use a large amount of irrigation fluid to obtain a surgical view during endoscopy, and this fluid can extravasate into the surrounding tissues.Abdominal compartment syndrome (ACS) is a serious condition that causes multi-organ dysfunction because of CASE REPORTA 75-year-old female patient (height: 150 cm, weight: 44 kg) was admitted for lower back pain, a tingling sensation in both calves, and left calf numbness. She was scheduled for left L5-S1 level laminectomy, diskectomy (compression fracture at the L4 level, L5-S1 level posterolateral disc herniation) and right L4-5 level endoscopic diskectomy (L4-5 level extraforaminal disc herniation).There was no specific disease except hypertension. Pre- Abdominal compartment syndrome can produce a critical situation if not diagnosed early and managed properly. We report a case of abdominal compartment syndrome that was caused by massive irrigation of surgical fluid during endoscopic lumbar diskectomy at the L4-L5 level. There was a sudden increase in peak inspiratory pressure during the operation, and the patient's tidal volume and blood pressure decreased. When the patient's position was changed from prone to supine, abdominal distension and cyanosis of both lower extremities were discovered. Ultrasonic findings showed fluid collection in both the chest and intra-abdominal cavity. Thoracentesis and abdominal decompression surgery were performed, and the patient's overall state improved. We concluded that irrigation fluid used during the endoscopic operation leaked into the retroperitoneal space and caused abdominal compartment syndrome.