We present a rare complication of Abdominal Compartment Syndrome (ACS) in a child undergoing complex urologic reconstruction. A 10-year-old female born with the abdominal wall defect cloacal exstrophy who had previously undergone multiple abdominal procedures then developed findings consistent with ACS following a complex mitrofanoff procedure.
Although intravesical pressures were not documented because of the nature of her reconstruction, her ACS-type findings were 1) abdominal pain 2) melena 3) pulmonary hypoinflation 4) renal insufficiency 5) tachycardia and 6) segmental ischemic small bowel. Management consisted of abdominal decompression, segmental bowel resections, and wound vacuum-assisted-closure management. Patient was eventually discharged home.
Urology. 2016 Feb 24 [Epub ahead of print]
Caleb E Cooper, Alfred P Kennedy, D Preston Smith
Pediatric Urology, East Tennessee Children's Hospital, 2100 Clinch Ave. MOB Suite 120, Knoxville, TN 37916, (865) 637-7290, Fax: (865) 637-7289. Pediatric Surgery, ,Geisinger Health System 100 N Academy Ave, Danville, PA 17822, (570) 271-7907. Pediatric Urology, East Tennessee Children's Hospital, 2100 Clinch Ave. MOB Suite 120, Knoxville, TN 37916.