Sindrome compartimentale addominale post-artroscopia d’anca. Una complicanza possibile?

ISSN： 0390-7368

Source： Archivio di Ortopedia e Reumatologia, Vol.121, Iss.2-3, 2010-11, pp. : 40-41

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Abstract

The Authors report a case of abdominal compartment syndrome that arose acutely in the phase of postoperative awakening after arthroscopic hip replacement. An analysis of literature data and of regional anatomical structures has allowed to hypothesize the possible aetiological mechanisms of this serious and rare complication, presenting with acute abdominal pain, respiratory distress, deficit of cardiac pump function, haemodynamic instability and oedema of both lower limbs with subcyanosis mimicking a bilateral “phlegmasia cerulea dolens”. The rarity of the complication in patients treated with this surgical technique suggests the possible coexistence of predisposing anatomical features and pathological conditions. An anamnesis of pathologies of the inguinal channel (hernias), of pelvic trauma or of abdominal wall surgery must alert the surgeon on the possible occurrence of this kind of adverse event. In programming the surgical intervention, a careful diagnostic planning cannot and must not be disregarded, in some cases including high-definition TC imaging and reconstruction of the anatomical structures of the pelvis. The therapy, simple once the aetiological mechanism was recognized, has allowed a prompt restoration of respiratory dynamics and venous return, with the normalisation of cardiovascular function. The post-operative course was uneventful, without debilitating outcomes from the complication.