Emergent abdominal decompression with patch abdominoplasty in the pediatric patient

Holly Neville, Kevin P. Lally, Charles S. Cox

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background/Purpose: Abdominal compartment syndrome (ACS) is the cardiac, pulmonary, and renal dysfunction that occurs as a result of elevated intraabdominal pressure. The authors present their experience with patch abdominoplasty (PA) in pediatric patients as a means to treat and prevent ACS. Methods: The charts of patients who underwent PA were reviewed retrospectively. ACS was defined as the increased oxygen requirements and elevation of peak inspiratory pressures (PIP) associated with abdominal distension and worsening renal and or cardiac function. Results: A total of 23 patients (13 boys) were treated (average age, 23 months). Diagnoses included necrotizing enterocolitis (NEC, n = 13), trauma (n = 3), Hirschsprung's enterocolitis (n = 2), perforated bowel (n = 4), and bilateral Wilms' tumor with bowel obstruction (n = 1). Oxygen requirements decreased after patch abdominoplasty (mean preoperative FlO 2, 0.87 ± 24, mean postoperative, 0.67 ± 24 [P = .01]). The PIP decreased significantly in the 13 patients who survived (mean preoperative PIP, 33 ± 8, mean postoperative PIP, 27 ± 7 [P= .01]). These PIPs failed to respond in the 8 nonsurvivors (mean preoperative PIP, 35 ± 10, mean postoperative PIP, 33 ± 14 [P value not significant]). Six of the 8 nonsurvivors had NEC. Complications of intraabdominal abscess and enterocutaneous fistula were seen in 5 patients, all of who had NEC. Conclusions: Patch abdominoplasty effectively decreases airway pressures and oxygen requirements associated with ACS. Complications with PA occur primarily in patients with NEC. Failure to respond with a decrease in PIP and FIO 2 requirements is an ominous sign. Copyright (C) 2000 by W.B. Saunders Company.

Original languageEnglish
Pages (from-to)705-708
Number of pages4
JournalJournal of Pediatric Surgery
Volume35
Issue number5
StatePublished - May 1 2000
Externally publishedYes

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Abdominoplasty
Lower Body Negative Pressure
Pediatrics
Pressure
Intra-Abdominal Hypertension
Oxygen
Intestinal Fistula
Kidney
Enterocolitis
Necrotizing Enterocolitis
Wilms Tumor
Abscess

Keywords

  • Abdominoplasty
  • Intraabdominal hypertension
  • Mesh

ASJC Scopus subject areas

  • Surgery

Cite this

Emergent abdominal decompression with patch abdominoplasty in the pediatric patient. / Neville, Holly; Lally, Kevin P.; Cox, Charles S.

In: Journal of Pediatric Surgery, Vol. 35, No. 5, 01.05.2000, p. 705-708.

Research output: Contribution to journalArticle

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