2024 · WORLD JOURNAL OF GASTROINTESTINAL SURGERY

Should we perform decompressive laparotomy during severe acute pancreatitis with intra-abdominal hypertension below 25 mmHg: Only the gut knows

Vieille, Thibault, Crotet, Melissa, Turco, Celia, Monasterolo, Paul, Winiszewski, Hadrien, Piton, Gael

Journal
WORLD JOURNAL OF GASTROINTESTINAL SURGERY
Année
2024
Volume
16
Numéro
5
Mois
MAY 27
DOI
10.4240/wjgs.v16.i5.1470

Abstract

We suggest that during severe acute pancreatitis (SAP) with intra-abdominal hypertension, practitioners should consider decompressive laparotomy, even with intra-abdominal pressure (IAP) below 25 mmHg. Indeed, in this setting, non-occlusive mesenteric ischemia (NOMI) may occur even with IAP below this cutoff and lead to transmural necrosis if abdominal perfusion pressure is not promptly restored. We report our experience of 18 critically ill patients with SAP having undergone decompressive laparotomy of which one third had NOMI while IAP was mostly below 25 mmHg.

Lire l'article complet