ASSESSMENT OF ABDOMINAL COMPARTMENT SYNDROME IN PATIENTS WITH SEVER ACUTE PANCREATITIS IN EARLY STAGE

Abstract

Background: Abdominal compartment syndrome (ACS) is a severe illness seen in critically ill
patients. It may be under recognized because it primarily affects patients who are already quite ill. We
aimed to to estimate the incidence of ACS in patients with AP in early stage and to evaluate intraabdominal pressure (IAP) as a marker of severity in acute pancreatitis and to ascertain the relationship
between IAP and development of complications in patients with severe acute pancreatitis (SAP).
Patients and methods: This prospective study was conducted in General Surgery Department, Faculty
of Medicine, ZagazigUniversity on 18 patients with AP admitted to the Surgical Intensive Care Unit
(SICU). All patients were recruited into two groups according to IAP determined during the first week
after admission. Patients with IAP ≥ 20mmHg were assigned in IAH group, and patients with IAP <
20mmHg in normal IAP group.
Results: APACHE was distributed as 3.94±1.35 as 50% were 71> (low) and 50% were <71 (high).
About 72.2% of studied group had no morbidity and 27.8% had comorbidities as 2 cases with HTN and
3 cases had DM, regard previous surgery only 5 cases had history of surgery. Lipase level was
distributed as Lipase mean of 959.72±103.58 with rang (800-1200). ACS cases were significantly
associated with longer hospital stay also with Bleeding, Septic shock and Mortality.
Conclusion: IAH and ACS are common finding in patients admitted to the ICU with severe acute
pancreatitis. IAH may worsen the severe acute pancreatitis. Early recognition of this potentially
treatable aggravating condition may lead to earlier intervention and hopefully improve the outcome.