A 50-year-old man on ICU with severe acute pancreatitis develops abdominal compartment syndrome (IAP 28 mmHg with multi-organ failure). Non-operative ...

Question

A 50-year-old man on ICU with severe acute pancreatitis develops abdominal compartment syndrome (IAP 28 mmHg with multi-organ failure). Non-operative measures (NG decompression, rectal tube, percutaneous drainage of ascites, neuromuscular blockade) have failed. What is the next step?

Accepted Answer

Decompressive laparotomy with temporary abdominal closure (open abdomen) - this is life-saving when non-operative measures fail for ACS

Answer

Continue conservative management

Answer

CT scan before any intervention

Answer

Increase PEEP to counteract the IAP

Answer

Peritoneal dialysis

uk-fficm MCQ (SBA): ACS - Decompressive Laparotomy

A 50-year-old man on ICU with severe acute pancreatitis develops abdominal compartment syndrome (IAP 28 mmHg with multi-organ failure). Non-operative measures (NG decompression, rectal tube, percutaneous drainage of ascites, neuromuscular blockade) have failed. What is the next step?