2016 Volume 36 Issue 6 Pages 1121-1124
A 63-year-old male with epigastric pain was diagnosed as having severe acute pancreatitis (CT grade 2) and hospitalized. On the 6th hospital day, the intra-abdominal pressure increased to 25 mmHg and the patient was diagnosed as having Abdominal Compartment Syndrome (ACS). Subcutaneous anterior abdominal fasciotomy was performed, with dissection between the posterior rectus abdominal sheath and the peritoneum. Thereafter, the pressure decreased to 11 mmHg and open abdominal management (OAM) with vacuum packing closure was started. On the 18th postoperative day, we applied a combination of the bilateral anterior rectus abdominal sheath turnover flap method and the components separation method (CSM) for repairing the fascia defect, which was 200 mm in length and 90 mm in width. On the 2nd postoperative day, a part of the skin became necrotic due to the tension of the suture, however, the patient did not develop recurrent ACS or ventral hernia. Use of a combination of the bilateral anterior rectus abdominal sheath turnover flap method and the CSM has not been reported before for abdominal closure after OAM reported, but proved effective in our case.
