A CASE OF TRAUMATIC ABDOMINAL COMPARTMENT SYNDROME THAT WAS DIFFICULT TO MANAGE

Abstract

　　We report a case of a 64-year-old man who was in a truck-to-truck traffic accident. He was diagnosed with “open book-type” right pelvic fracture and multiple open fractures of both lower limbs. We performed orthopedic external fixation of the lower extremities ; however, he developed abdominal compartment syndrome (ACS) during surgery. Although circulatory-respiratory dynamics on day 2 of hospitalization were stabilized with open abdomen management (OAM), ACS recurred when the abdominal fascia was definitively closed. OAM was reintroduced on day 4 and the fascia finally closed on day 11. The patient was discharged on day 81 with no recurrence or complications of ACS. There was no consensus on the diagnosis and treatment strategy of ACS among the medical staff, and the case was difficult to manage.