Document Detail

The effect of abdominal wall plication on intra-abdominal pressure and lower extremity venous flow: a case report.
MedLine Citation:
PMID:  21855437     Owner:  NLM     Status:  MEDLINE    
Abdominal wall plication is known to cause increased intra-abdominal pressure (IAP). Whether plication-associated increased IAP causes lower extremity venous stasis, a recognized risk factor for DVT, remains unknown. A 55-year-old woman had a unilateral pedicled TRAM procedure for mastectomy reconstruction. Prior to plication, duplex ultrasound measured proximal femoral vein (PFV) cross-sectional diameter and volume-flow. PFV measurements were repeated immediately after plication and on post-operative days (POD) 1, 2, and 4. Bladder pressure was measured at similar timepoints. PFV volume-flow decreased from 0.22 L/min to 0.16 L/min (73% of baseline) immediately post-plication and reached a nadir of 0.08 L/min (36% of baseline) on POD 2. Bladder pressure increased from 13 mm Hg to 19 mm Hg after plication, and peaked at 31 mm Hg after intra-operative trunk flexion to 30°. Thus, abdominal wall plication was associated with increased intra-abdominal pressure and ultrasound-documented lower extremity venous stasis that persisted for 48 h after surgery.
Christopher J Pannucci; Amy K Alderman; Sandra L Brown; Thomas W Wakefield; Edwin G Wilkins
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-08-19
Journal Detail:
Title:  Journal of plastic, reconstructive & aesthetic surgery : JPRAS     Volume:  65     ISSN:  1878-0539     ISO Abbreviation:  J Plast Reconstr Aesthet Surg     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-13     Completed Date:  2012-04-03     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  101264239     Medline TA:  J Plast Reconstr Aesthet Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  392-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Section of Plastic Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
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MeSH Terms
Abdomen / physiopathology*,  surgery
Abdominal Wall / surgery*
Blood Flow Velocity
Intra-Abdominal Hypertension / complications*,  physiopathology
Lower Extremity / blood supply*,  ultrasonography
Mammaplasty / adverse effects*
Middle Aged
Surgical Flaps / adverse effects*,  blood supply
Venous Thrombosis / etiology*,  physiopathology,  ultrasonography
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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