Secondary abdominal compartment syndrome after complicated traumatic lower extremity vascular injuries

F. I.B. Macedo, J. D. Sciarretta, C. A. Otero, Gabriel Ruiz, D. J. Ebler, L. R. Pizano, N. Namias

Research output: Contribution to journalArticle

Abstract

Introduction: Secondary abdominal compartment syndrome (ACS) can occur in trauma patients without abdominal injuries. Surgical management of patients presenting with secondary ACS after isolated traumatic lower extremity vascular injury (LEVI) continues to evolve, and associated outcomes remain unknown. Methods: From January 2006 to September 2011, 191 adult trauma patients presented to the Ryder Trauma Center, an urban level I trauma center in Miami, Florida with traumatic LEVIs. Among them 10 (5.2 %) patients were diagnosed with secondary ACS. Variables collected included age, gender, mechanism of injury, and clinical status at presentation. Surgical data included vessel injury, technical aspects of repair, associated complications, and outcomes. Results: Mean age was 37.4 ± 18.0 years (range 16–66 years), and the majority of patients were males (8 patients, 80 %). There were 7 (70 %) penetrating injuries (5 gunshot wounds and 2 stab wounds), and 3 blunt injuries with mean Injury Severity Score (ISS) 21.9 ± 14.3 (range 9–50). Surgical management of LEVIs included ligation (4 patients, 40 %), primary repair (1 patient, 10 %), reverse saphenous vein graft (2 patients, 20 %), and PTFE interposition grafting (3 patients, 30 %). The overall mortality rate in this series was 60 %. Conclusions: The association between secondary ACS and lower extremity vascular injuries carries high morbidity and mortality rates. Further research efforts should focus at identifying parameters to accurately determine resuscitation goals, and therefore, prevent such a devastating condition.

Original languageEnglish (US)
Pages (from-to)207-211
Number of pages5
JournalEuropean Journal of Trauma and Emergency Surgery
Volume42
Issue number2
DOIs
StatePublished - Apr 1 2016

Keywords

  • Abdominal compartment syndrome
  • Blunt
  • Lower extremity trauma
  • Penetrating
  • Vascular injury

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Orthopedics and Sports Medicine
  • Critical Care and Intensive Care Medicine

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