Acute abdominal compartment syndrome as a complication of Holmium laser enucleation of the prostate: a case report

BMC Anesthesiology - Tập 14 - Trang 1-4 - 2014
Torsten Richter1, Matthias Huebler1
1Department of Anesthesia and Intensive Care, Carl Gustav Carus University Hospital, Dresden, Germany

Tóm tắt

In 1996, Holmium laser enucleation of the prostate was introduced and has been shown to be safe and highly effective. We report a case of a rare complication that resulted in intra-abdominal compartment syndrome with prolonged intubation and intensive care, involving an 74-year-old male after holmium laser enucleation of prostate, with a massive irrigant fluid leakage into the retroperitoneal space. The elevated abdominal pressure was reduced by forced diuresis. The tracheal tube was removed 18 hours after the patient’s transfer to the ICU. The patient was discharged to home one week after the operation. In rare cases when no obvious ruptures of the prostate capsule or the bladder occur during laser enucleation of prostate, knowledge regarding possible emersion of massive amounts of irrigant fluid into the retroperitoneal space leading to intra-abdominal compartment syndrome aids in the diagnosis and subsequent successful therapy of intra-abdominal hypertension.

Tài liệu tham khảo

Tan AH, Gilling PJ: Holmium laser prostatectomy. BJU Int. 2003, 92 (6): 527-530. 10.1046/j.1464-410X.2003.04426.x. Elmansy HM, Kotb A, Elhilali MM: Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of followup. J Urol. 2011, 186 (5): 1972-1976. 10.1016/j.juro.2011.06.065. Shah HN, Mahajan AP, Hegde SS, Bansal MB: Peri-operative complications of holmium laser enucleation of the prostate: experience in the first 280 patients, and a review of literature. BJU Int. 2007, 100 (1): 94-101. 10.1111/j.1464-410X.2007.06867.x. Tan AH, Gilling PJ, Kennett KM, Frampton C, Westenberg AM, Fraundorfer MR: A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). J Urol. 2003, 170 (4 Pt 1): 1270-1274. Vavassori I, Hurle R, Vismara A, Manzetti A, Valenti S: Holmium laser enucleation of the prostate combined with mechanical morcellation: two years of experience with 196 patients. J Endourol/Endourological Society. 2004, 18 (1): 109-112. 10.1089/089277904322836767. Ritchie DA, Frazer CK, Taylor AD, Newling DW: Ultrasonic detection of a retroperitoneal haematoma causing duodenal obstruction following ureterolithotomy. Brit J Radiol. 1990, 63 (753): 726-728. 10.1259/0007-1285-63-753-726. McCullough DL, Leopold GR: Diagnosis of retroperitoneal fluid collections by ultrasonography: a series of surgically proved cases. J Urol. 1976, 115 (6): 656-659. Wachsberg RH, Singh-Panghaal S: Retroperitoneal edema: sonographic mimic of retroperitoneal fluid collection. Abdom Imaging. 1998, 23 (1): 103-106. 10.1007/s002619900296. Hurle R, Vavassori I, Piccinelli A, Manzetti A, Valenti S, Vismara A: Holmium laser enucleation of the prostate combined with mechanical morcellation in 155 patients with benign prostatic hyperplasia. Urology. 2002, 60 (3): 449-453. 10.1016/S0090-4295(02)01812-5. El-Hakim A, Elhilali MM: Holmium laser enucleation of the prostate can be taught: the first learning experience. BJU Int. 2002, 90 (9): 863-869. 10.1046/j.1464-410X.2002.03071.x. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2253/14/32/prepub