Anastomatic Leak And Intraabdominal Compartment Syndrome

Question 1

Clinical findings of an anastomatic leak

Answer 1

Fever, leukocytosis, tachycardia, hypotension
Enteric contents in perianastomotic drain

Question 2

How to diagnose an anastomotic leak

Answer 2

CT with PO contrast

Question 3

Treatment plan for anastomotic leak

Answer 3

Surgical revision in septic shock and generalized peritonitis patients
IF hemodynamically stable ABX Percutaneous drain and possible endoscopy with stent

Question 4

Causes of intraabdominal compartment syndrome

Answer 4

Abdominal trauma
Abdominal surgery
Deep burns
Obesity
Intraabdominal or retroperitoneal hemorrhage
Excessive IVF or blood products

Question 5

What pressure indicates intraabdominal hypertension

Answer 5

> 12mm hg

Question 6

What pressure level indicates abdominal compartment syndrome

Answer 6

> 20mmhg

Question 7

Clinical manifestations of abdominal compartment syndrome

Answer 7

Tense distended abdomen
Increased PIP and decreased TV
Post op persistent metabolic acidosis and shock

Question 8

Diagnosis of intraabdominal syndrome

Answer 8

CT or Endo
Abdominal pressure measurement

Question 9

Treatment for abdominal compartment syndrome

Answer 9

IAH or early ACS: decrease volume resuscitation, add sedation and neuromuscular blockage
ACS: surgical decompression via celiotomy, negative pressure dressing