外科ジャーナル

Abdominal Compartment Syndrome–Severe Complication of Giant Abdominal Tumor: Case Report and Literature Review

Abstract

Mircea Mureșan, Simona Mureșan, Daniela Sala, Miana Gliga, Ioana Halmaciu, Klara Brînzaniuc, Popescu Gabriel and Radu Mircea Neagoe

Introduction: Giant abdominal tumors, as a result of volume mass and dimensions , even benign being, can develop serious complications. The differential diagnosis includes cystic or solid disorders of the female genitals, ascites, cysts or hydronephrosis, pancreatic cysts or pseudocysts, gastrointestinal stromal tumors.

Case presentation: A 44 years old patient, was hospitalized for an giant abdominal tumor formation, pain, weight loss, nausea and vomiting. Laboratory data show changes in the sense of acute renal failure. Ultrasound examination reveals layout of carcinomatous ascites and native CT scanning, a giant cyst, without being able to specify their organ affiliation. The central venous pressure monitoring showed low values (less then 1 cm water), and intra-abdominal pressure, measured indirectly using the urinary catheter, revealed an increased value (25 mmHg). Patient undergone a midline laparotomy and it was found a giant cyst developed from from the left ovary. It was performed cystectomy associated with hysterectomy and controlateral ovariectomyl. The postoperative course was favorable and the patient discharged on day 6. Histopathology confirmed a mucinous cystadenoma

Conclusions: Abdominal compartment syndrome is a severe complication of giant abdominal tumors, which must be solved immediatly by medical therapy and/or surgery. Choosing the type of surgery (open or laparoscopic) depends on tumor size and the possibility and establishing the preoperative histopathological diagnosis.