Authors:
Zsuzsanna Mihály Semmelweis Egyetem Érsebészeti Tanszék 1124 Budapest Városmajor u. 68.

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Kristóf Perczel Semmelweis Egyetem Aneszteziológiai és Intenzív Terápiás Klinika Budapest

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Gergely Csikós Semmelweis Egyetem Aneszteziológiai és Intenzív Terápiás Klinika Budapest

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Zoltán Szeberin Semmelweis Egyetem Érsebészeti Tanszék 1124 Budapest Városmajor u. 68.

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Magyarországon elsőként közöljük esetünket, amelyben sikerrel alkalmaztunk nyitott hasi és VAC- (vákuumasszisztált sebzárás) kezelést aortaaneurysma-ruptura miatt kialakuló hasi compartmentsyndroma megelőzéseként. Esetismertetés: Az 59 éves nőbeteg acutan került felvételre klinikánkra, akinél az angio-CT-vizsgálat fedett hasi aortaaneurysma-rupturát igazolt. Az acut laparotomiából végzett aortoaorticus Dacron graft interpositióját követően, a has zárásakor a beteg lélegeztethetetlenné vált a vékony- és vastagbél hosszú szakaszát érintő oedemája és a retroperitonealis vérgyülem okozta megemelkedett hasűri nyomás miatt. Ezért nyitott hasi kezelés és VAC-terápia mellett döntöttünk. Az ismételt kötéscseréket követően a has halasztott zárása DualMesh hálóval történt, három héttel később a beteg otthonába távozott. Megbeszélés: Esetünkben a nagyfokú oedema és a retroperitonealis haematoma miatt a fedett hasi aortaaneurysma-ruptura műtéti megoldását követően a has zárása már nem volt kivitelezhető. Az intraabdominalis nyomásfokozódás szövődményei megakadályozhatók voltak a nyitott hasi kezelésnek köszönhetően. Esetünk tapasztalata és a szakirodalom ajánlása alapján javasoljuk a nyitott hasi kezelést VAC-rendszerrel kombinálva hasi compartmentsyndroma esetén.

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    Wanhainen A , 'Management of abdominal compartment syndrome and the open abdomen ' (2014 ) 47 Eur J Vasc Endovasc Surg : 279 -87 .

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  • Cheatham ML, Malbrain ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, Balogh Z, Leppaniemi A, Olvera C, Ivatury R, D’Amours S, Wendon J, Hillman K, Wilmer A: Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. II. Recommendations. Intensive Care Med 2007; 33: 951–62

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    Rotondo MF , 'Prospective study examining clinical outcomes associated with a negative pressure wound therapy system and Barker’s vacuum packing technique ' (2013 ) 37 World J Surg : 2018 -30 .

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  • DR. BÁLINT ANDRÁS
  • DR. BEZSILLA JÁNOS
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2020  
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Magyar Sebészet
Language Hungarian
Size A4
Year of
Foundation
1947
Volumes
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1
Issues
per Year
4
Founder Magyar Sebész Társaság -- Hungarian Surgical Society
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Address
H-1082 Budapest, Hungary Üllői út 78.
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ISSN 0025-0295 (Print)
ISSN 1789-4301 (Online)

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