“INTRAABDOMINAL HYPERTENSION AND ABDOMINAL COMPARTMENT SYNDROME IN EMERGENCY LAPAROTOMY PATIENTS IN TERTIARY CARE RURAL HOSPITAL”

Abstract

Background: Although initially recognized over 150 years ago, the patho-physiologic implications of elevated intra-abdominal pressure (IAP) have essentially been rediscovered only within the past two decades. The aim of the study was to evaluate the incidence, morbidity and mortality of intra abdominal hypertension and abdominal compartment syndrome in emergency laparotomy patients in tertiary care rural hospital.

Method:  IAP measurement was done in all patients undergoing emergency laparotomy with manometry technique (U tube technique) using per- urethral foley's catheterization.

Results: Our study population was a group of patients who underwent laparotomy for various indications which included traumatic as well as non-traumatic causes. In total, 104 patients, with 30 females and 74 males were included in the study population who fulfilled the study criteria. The mean ± SD age in our study were 40.2±13 years with 20-30yrs being the most common age group. Most of the studies on IAH and ACS analyse either trauma or ICU patients. Little has been reported on ACS in general surgical population. Our study population was a group of patients who underwent laparotomy for various indications which included traumatic as well as non traumatic causes, hence a predominance of general surgical patients.

Conclusions: Findings suggest that the incidence of ACS in our study is 3.84 % and found to be more common in trauma patients. There is significant association between increased Intra-abdominal pressure at 6 and 24 hours after laparotomy and organ dysfunction. The total mortality rate in ACS group was 75%. There is significant association between increased Intra-abdominal pressure and mortality.