Postoperative gastric dilatation causing abdominal compartment syndrome

Single case report from a primary teaching hospital.A 72-year-old woman demonstrated a sudden respiratory and cardiovascular collapse following resection of a retroperitoneal sarcoma. This collapse was caused by abdominal compartment syndrome due to gastric dilatation.The patient was re-explored, an enormously distended stomach was found with the nasogastric tube situated in a small sliding hernia which prevented drainage of the distended stomach. Re-positioning of the nasogastric tube, allowed the decompression of the stomach and the patient's condition immediately improved.Acute abdominal distention following major abdominal surgery may result from acute gastric dilatation, leading to oliguria and increased airway pressures. Untreated gastric dilatation can cause abdominal compartment syndrome.Abdominal compartment syndrome (ACS) is defined as an increased intra-abdominal pressure (IAP > 20 mmHg) in combination with single or multiple organ dysfunction which was not previously present [1-3]. This condition affects multiple organ systems in graded fashion [4]. Early identification and abdominal decompression are essential in the management and treatment of this difficult situation, otherwise, it leads to multiple organ failure and ultimately, death [5]. Increased intra-peritoneal volume conditions are the most common source of elevated IAP [6,7]. Extrinsic compression of the abdomen by burn eschars [8], pneumatic anti-shock garments [9], tight abdominal closure [10], massive volume resuscitation for any reason, and inflation of the peritoneum by CO2 in laparoscopic surgery can also lead to increased IAP [11]. We present a rare case of abdominal compartment syndrome caused by postoperative gastric dilatation in 72-year-old woman.A 72-year-old woman was addmitted for elective resection of retroperitoneal sarcoma. The diagnosis was done by CT scan and pathological confirmation by explorative laparotomy 3 weeks before in another institution. At operation complete resec