First Report of Fatal Secondary Abdominal Compartment Syndrome Induced by Intestinal Gas Accumulation Without Organic Occlusive Intestinal Lesion in a Child with Sepsis

Overview

Journal Am J Case Rep

Specialty General Medicine

Date 2019 Jul 14

PMID 31300635

Authors

Ryuta Itakura

Natsuko Takayanagi

Shingo Kobayashi

Yoshio Sakurai

Yoichi Iwamoto

Hirotaka Ishido

Koichi Moriwaki

Jun-Ichi Tamaru

Satoshi Masutani

Affiliations

Soon will be listed here.

Abstract

BACKGROUND Abdominal compartment syndrome (ACS), characterized by an increased intra-abdominal pressure and new-onset organ dysfunction, is a critical and potentially fatal condition, with no case of ACS caused by intestinal gas without intestinal lesion being reported to date. CASE REPORT A 2-year-old girl with a chromosomal abnormality of 1p36 deletion presented with fever and diarrhea following upper-gastrointestinal series for the evaluation of gastroesophageal reflux. After 20 days, she experienced septic shock and multiple-organ failure, accompanied with rapidly growing, severe abdominal distension. A marked increase in the intra-abdominal pressure was indicated by the complete loss of elasticity in the extremely hard and distended abdomen. She died 14 h after the onset of shock. Her autopsy examination revealed extensive pneumonia and excessive intestinal gas, despite no occlusive intestinal lesion present. CONCLUSIONS It is critical to be aware that secondary ACS can occur following sepsis due to the accumulation of extensive intestinal gas, without an occlusive intestinal lesion.

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