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Case Report
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| Decompressive laparotomy for reduction of incessant increased intracranial pressure in the absence of abdominal compartment syndrome: A case report | ||||||
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Mark Armanious1,
Louise N Bacon1,
Johnny Harris1,
Shayla George1,
Kristen-Kaye Goulbourne1,
Omar K Danner2,
L Ray Matthews1, Kenneth L Wilson2 | ||||||
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1MD, Morehouse School of Medicine, Atlanta GA.
2MD, Assistant Professor, Department of Surgery, Morehouse School of Medicine, Atlanta, GA. | ||||||
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| How to cite this article: |
| Armanious M, Bacon LN, Harris J, George S, Goulbourne K, Danner OK, Matthews LR, Wilson KL. Decompressive laparotomy for reduction of incessant increased intracranial pressure in the absence of abdominal compartment syndrome: A case report. International Journal of Case Reports and Images 2013;4(8):419–422. |
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Abstract
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Introduction:
A novel approach for the management of severe traumatic brain injury is to perform a decompressive laparotomy when controlling intracranial hypertension (ICH) appears futile. Bladder pressures measured above 20 mmHg are used to signify the presence of an abdominal compartment syndrome and indicate the need for a decompressive laparotomy.
Case Report: We are presenting a case study of a 16-year-old male who sustained a gunshot wound to the head that resulted in a severe traumatic brain injury and incessantly elevated intracranial pressures (ICP). The patient did not demonstrate a sustained and significant reduction in his ICH following a decompressive craniectomy. We performed a decompressive laparotomy successfully reducing the patient’s ICP below 20 mmHg. The patient survived to discharge and was neurologically improved at follow-up. Conclusion: This case highlights the importance of regarding the body a continuous compartment allowing a reduction in intracranial pressure by decompressing the abdomen even in the absence of an abdominal compartment syndrome measured by elevated bladder pressures above 20 mmHg. | |
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Keywords:
Intracranial hypertension (ICH), Cerebral perfusion pressure (CPP), Abdominal compartment syndrome (ACS), Decompressive laparotomy, Brain injury
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Author Contributions
Mark Armaniious – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article or revising it critically for important intellectual content, Final approval of the version to be published Louise Bacon – Substantial contributions to conception and design, Acquisition of data, or analysis and interpretation of data, Drafting the article or revising it critically for important intellectual content, Final approval of the version to be published Johnny Harris – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article or revising it critically for important intellectual content, Final approval of the version to be published Shayla George – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article or revising it critically for important intellectual content, Final approval of the version to be published Kristen-Kaye Goulbourne – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article or revising it critically for important intellectual content, Final approval of the version to be published Omar K Danner – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article or revising it critically for important intellectual content, Final approval of the version to be published L Ray Matthews – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article or revising it critically for important intellectual content, Final approval of the version to be published Kenneth L Wilson – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article or revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Mark Armaniious et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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