Abstract
A 76-year-old male had not defecated for 4 days and was brought to our hospital by ambulance with impaired consciousness and difficulty with moving his body. He was in a state of shock and his abdomen was distended. Computed tomography revealed marked dilatation of the entire intestinal tract, especially the colon, which led to the diagnosis of abdominal compartment syndrome and septic shock. The patient underwent emergency laparotomy, abdominal decompression, and open abdomen management （OAM） using the vacuum-assisted closure （VAC） method. On the 3rd day, the patientʼs circulatory failure had improved; respiratory failure due to aspiration pneumonia and atelectasis persisted. Although the patient was undergoing OAM, prone ventilation was performed and worked well. In patients exhibiting flattened abdomen during OAM, ventilation in the prone position may be a treatment option, provided that careful attention is devoted to circulatory dynamics, device handling, and intra-abdominal pressure monitoring.
