Abdominal Compartment Syndrome (ACS) With Sigmoid Volvulus (SV): Lost Hours Are Lost Lives

Andrea C Marin; Sharon Hechter; Ankita Prasad; Dina Alnabwani; Charles Lwoodsky; Pramil Cheriyath

doi:10.7759/cureus.33741

Abdominal Compartment Syndrome (ACS) With Sigmoid Volvulus (SV): Lost Hours Are Lost Lives

Cureus. 2023 Jan 13;15(1):e33741. doi: 10.7759/cureus.33741. eCollection 2023 Jan.

Authors

Andrea C Marin¹, Sharon Hechter², Ankita Prasad³, Dina Alnabwani⁴, Charles Lwoodsky², Pramil Cheriyath⁴

Affiliations

¹ Internal Medicine, Hackensack Meridien Health Ocean Medical Center, Brick, USA.
² Internal Medicine, Hackensack Meridian Health Ocean Medical Center, Brick, USA.
³ Internal Medicine, Hackenasck Meridian Health Ocean Medical Center, Brick, USA.
⁴ Internal Medicine, Hackensack Meridian Health, Ocean Medical Center, Brick, USA.

Abstract

Normal intra-abdominal pressure (IAP) ranges from 0 to 5, and abdominal compartment syndrome (ACS) occurs when a sustained IAP >20 mmHg causes organ dysfunction. ACS mainly occurs in patients who are critically ill. It occurs due to an injury or disease in the abdomen or pelvic area, including trauma, abdominal surgery, acute pancreatitis, pancreatic ileus, volvulus, fecal impaction, and ruptured abdominal aortic aneurysm. If not recognized early, ACS leads to multiorgan dysfunction, shock, and sepsis and has high morbidity and mortality. Our patient was brought to the emergency department (ED) following cardiac arrest and resuscitation and was diagnosed with sigmoid volvulus (SV) and ACS. SV is seen in older men, and its presentation is often insidious and leads to bowel gangrene and ACS. The patient's delay in presenting to the hospital and the severity of his condition leads to a poor outcome despite surgery. A delay in recognizing ACS can lead to a worse outcome.

Keywords: anterior compartment syndrome; gangrene; intraabdominal pressure; ischemia; perforation; peritonitins; prognosis; sepsis; shoch; sigmoid volvulus.

Publication types

Case Reports