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Abdominal compartment syndrome in children: CT findings
Monica Epelman1, Michal Soudack, Ahuva Engel
1Department of Radiology, Rambam Medical Centre and the Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Bat-Galim, Haifa 31096, Israel. monica_epelman@hotmail.com
Insights
Abdominal compartment syndrome (ACS) is a critical condition of elevated intra-abdominal pressure (IAP). Pre-operative CT scans in children revealed key signs like IVC narrowing and bowel wall thickening, aiding early diagnosis.
Area of Science:
- Radiology
- Pediatric Surgery
- Critical Care Medicine
Background:
- Abdominal compartment syndrome (ACS) results from elevated intra-abdominal pressure (IAP), leading to organ dysfunction and high mortality.
- Early diagnosis of ACS is crucial for timely intervention and improved patient outcomes.
Observation:
- This study reviewed pre-operative abdominal CT scans of three pediatric patients diagnosed with ACS.
- The objective was to identify radiologic indicators of elevated IAP on CT.
Findings:
- Common CT findings in pediatric ACS included inferior vena cava (IVC) narrowing, renal compression or displacement, and bowel wall thickening with enhancement.
- A rounded abdominal contour was also noted as a potential sign of increased intra-abdominal pressure.
Implications:
- Recognizing these CT findings can assist in the prompt diagnosis and surgical planning for emergency decompression in pediatric ACS.
- Radiologists should be aware of these signs to effectively communicate critical information to clinicians in emergent situations.
Abstract:
Abdominal compartment syndrome (ACS) is caused by pathological elevation of intra-abdominal pressure (IAP) leading to multiple organ dysfunction syndrome. Since the condition is highly lethal, early diagnosis is imperative. We evaluated the pre-operative abdominal CT scans of three children with proven ACS to identify signs of elevated IAP. Findings common to these patients included narrowing of the inferior vena cava (IVC), direct renal compression or displacement, bowel wall thickening with enhancement and a rounded appearance of the abdomen. The aim of recognising the CT findings in such cases is to plan emergency surgical decompression. Although these findings are not specific for increased IAP, radiologists should be aware of this life-threatening condition and, in the proper clinical setting, should communicate the presence and significance of these findings to the referring clinician.