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Abdominal compartment syndrome in a patient with congenital megacolon
1Department of Emergency Medicine, New York Methodist Hospital, Brooklyn 11215, USA. rhbirkhahn@pol.net
Insights
A pediatric patient with congenital megacolon developed abdominal compartment syndrome due to massive colonic dilation. Surgical decompression led to a reperfusion phenomenon, coagulopathy, and ultimately, demise.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Critical Care Medicine
Background:
- Congenital megacolon is a rare condition characterized by abnormal dilation of the colon.
- Abdominal compartment syndrome (ACS) is a life-threatening condition resulting from increased intra-abdominal pressure.
- Massive colonic dilation in pediatric patients can precipitate ACS.
Abstract:
A 13-year-old male with a history of chronic congenital megacolon presented to the emergency department with a 1-day history of increasing abdominal pain, distension, and emesis. The patient was admitted for bowel disimpaction and irrigation. The patient rapidly developed an acute abdominal compartment syndrome because of his massive colonic dilation. Surgical decompression resulted in a reperfusion phenomenon and ultimately resulted in coagulopathy and patient demise. This case presents a unique cause of the abdominal compartment syndrome and discusses the implications to the emergency physician.