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Case Reports in Medicine
Volume 2012 (2012), Article ID 946103, 6 pages
http://dx.doi.org/10.1155/2012/946103
Case Report

Correct the Coagulopathy and Scoop It Out: Complete Reversal of Anuric Renal Failure through the Operative Decompression of Extraperitoneal Hematoma-Induced Abdominal Compartment Syndrome

1Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada T2N 2T9
2Critical Care Medicine, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada T2N 2T9
3Regional Trauma Program, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada T2N 2T9

Received 15 October 2012; Accepted 26 November 2012

Academic Editor: Yasuhiko Sugawara

Copyright © 2012 Paul B. McBeth et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report two cases of extraperitoneal compression of the intra-abdominal space resulting in abdominal compartment syndrome (ACS) with overt renal failure, which responded to operative decompression of the extra-peritoneal spaces. This discussion includes patient presentation, clinical course, diagnosis, interventions, and outcomes. Data was collected from the patient’s electronic medical record and a radiology database. ACS appears to be a rare but completely reversible complication of both retroperitoneal hematoma (RH) and rectus sheath hematoma (RSH). In patients with large RH or RSH consideration of intra-abdominal pressure (IAP) monitoring combined with aggressive operative drainage after correction of the coagulopathy should be considered. These two cases illustrate how a relatively benign pathology can result in increased IAP, organ failure, and ultimately ACS. Intervention with decompressive laparotomy and evacuation of clot resulted in return to normal physiologic function.