Abstract
Objectives: Abdominal compartment syndrome (ACS) is an important factor in the development of multiple organ failure (MOF). With the aim of preventing ACS, we used open management for patients who had undergone critical ruptured abdominal aortic aneurysm (AAA) repair, and investigated the efficacy of open management on MOF and mortality. Methods: We performed a case-control study of patients who required open management (n=10) and compared the results with those of patients who underwent primary closure (n=10) after ruptured AAA repair. Results: Prior to surgery, the patients who required open management had long-term hypotension and needed cardiopulmonary resuscitation more frequently than the patients who underwent primary closure. During surgery, the patients who required open management had more blood loss and more severe acidosis than the patients who underwent primary closure. The mortality rate of the patients who required open management was 10%, whereas that of the patients who underwent primary closure was 0%. If they had an adverse clinical profile, the patients who required open management had more instances of organ failure. Therefore, we gave those patients large intravenous infusions to treat postoperative shock and renal failure. Conclusion: Open management in patients with critical ruptured AAA is effective in treating and preventing ACS.
