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CASE REPORT
Paediatric abdominal compartment syndrome and shock associated with gastric volvulus improved rapidly by gastric suction in the emergency department
  1. Kenichi Tetsuhara1,
  2. Satoshi Tsuji1 and
  3. Kotaro Tomonaga2
  1. 1 Division of Pediatric Emergency and Transport Services, National Center for Child Health and Development, Tokyo, Japan
  2. 2 Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
  1. Correspondence to Dr Kenichi Tetsuhara, ken-tetsuhara{at}mti.biglobe.ne.jp

Abstract

Abdominal compartment syndrome (ACS) is not rare and has a high mortality in the paediatric intensive care unit. However, there are few reports about this in the emergency department (ED). We report an 8 month-old male patient with ACS in shock associated with gastric volvulus who improved rapidly by a simple procedure in the ED. He had congenital comorbidities, including multiple cranial anomalies and was transferred because of decreased mental status. He had compensated shock with cold and mottled skin of the lower extremities, paediatric Glasgow Coma Scale of E3V5M6 and prominence of the left upper abdomen. The abdominal X-ray showed a considerably distended stomach. Soon after aspiration of gastric contents, shock and mental status improved. Physicians should consider ACS in the differential diagnosis of shock with abdominal distention. ACS may be ameliorated by gastric suction. Gastric volvulus can induce shock and decreased mental status, particularly in patients with comorbidities.

  • resuscitation
  • paediatrics
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Footnotes

  • Contributors KTe was responsible for the idea and obtained the consent from the patient’s mother. KTe and ST managed the patient in the emergency department and drafted the initial manuscript. KTo managed the patient as a surgery consultant, operated and reviewed the manuscript. All the authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/guardian consent obtained.

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