Abdominal Compartment Syndrome: A Rare but Fatal Complication of Percutaneous Nephrolithotomy
Sujeet Poudyal *
Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Bipendra Dhoj Kulung Rai
Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Pawan Dhital
Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Manish Pradhan
Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Suman Chapagain
Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Bhoj Raj Luitel
Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Pawan Raj Chalise
Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Uttam Kumar Sharma
Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Prem Raj Gyawali
Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
*Author to whom correspondence should be addressed.
Abstract
Background: Percutaneous Nephrolithotomy (PCNL) is the standard of treatment for large renal stones. Intra-abdominal hypertension during PCNL due to extravasation of irrigation fluid in the peritoneal cavity may lead to organ dysfunction and may be fatal if not intervened on time.
Case Presentation: We report a case of abdominal compartment syndrome as a complication of PCNL. After a timely diagnosis, the case was managed successfully with percutaneous intraperitoneal drainage.
Conclusion: It is imperative to be aware of raised intra-abdominal pressure during PCNL to prevent abdominal compartment syndrome and to avoid its fatal outcome.
Keywords: Abdominal compartment syndrome, Intra-abdominal pressure, peak airway pressure, percutaneous nephrolithotomy, pigtail drain