| Surgical decompression for abdominal compartment syndrome in severe acute pancreatitis. | |
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MedLine Citation:
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PMID: 20713929 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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HYPOTHESIS: In patients with severe acute pancreatitis and abdominal compartment syndrome, establishment of the indications and optimal time for surgical decompression may avoid exacerbation of multiple-organ dysfunction syndrome. DESIGN: Retrospective study. SETTING: Tertiary care university teaching hospital. PATIENTS: Twenty-six consecutive patients with severe acute pancreatitis and abdominal compartment syndrome treated by surgical decompression between January 1, 2002, and December 31, 2007. INTERVENTION: Surgical decompression of the abdomen. MAIN OUTCOME MEASURES: Morbidity, mortality, and organ dysfunction before and after surgical decompression. RESULTS: At the time of surgical decompression, the median sequential organ failure assessment score among patients was 12 (interquartile range, 10-15), and the median intra-abdominal pressure was 31.5 (interquartile range, 27-35) mm Hg. After surgical decompression, renal or respiratory function was improved in 14 patients (54%). The overall hospital mortality was 46%, but mortality was 18% among 17 patients in whom surgical decompression was performed within the first 4 days after disease onset. CONCLUSIONS: Patients with severe acute pancreatitis and abdominal compartment syndrome managed by surgical decompression had severe multiple-organ dysfunction syndrome and high mortality. Surgical decompression may improve renal or respiratory function. Early surgical decompression is associated with reduced mortality in patients with severe acute pancreatitis, early multiple-organ dysfunction syndrome, and abdominal compartment syndrome. |
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Authors:
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Panu Mentula; Piia Hienonen; Esko Kemppainen; Pauli Puolakkainen; Ari Leppäniemi |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 145 ISSN: 1538-3644 ISO Abbreviation: Arch Surg Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-17 Completed Date: 2010-09-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: United States |
Other Details:
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Languages: eng Pagination: 764-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Gastroenterologic and General Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HUS, Helsinki, Finland. panu.mentula@hus.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen Adult Compartment Syndromes / etiology, mortality, surgery* Decompression, Surgical* Disease Progression Female Hospital Mortality Humans Male Middle Aged Multiple Organ Failure / prevention & control Pancreatitis / complications*, mortality Reoperation / statistics & numerical data Retrospective Studies Risk Factors Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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