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ORIGINAL ARTICLE
Year : 2016  |  Volume : 33  |  Issue : 2  |  Page : 103-107

Intra-abdominal pressure as a criterion for abdominal re-exploration: a prospective study


Department of General Surgery, Benha University Hospitals, Benha, Egypt

Correspondence Address:
Ahmed Moustafa
Department of General Surgery, Benha University Hospitals, Benha, 13518
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-208X.201282

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This prospective study was designed to evaluate the role of intra-abdominal pressure (IAP) measurement during the early postoperative period as a criterion of the need for re-exploration. The study comprised 90 patients; 60 (66.7%) males and 30 (33.3%) females, with mean age of 45.15 ± 11.9. All patients were assigned to undergo exploratory laparotomy for acute abdomen for various indications. Each patient underwent single preoperative and 8-h postoperative serial IAP measurements for a period of 72 h through two-ways indwelling Foley's catheter. Twelve patients underwent relaparatomy, 10 had a significant increase in IAP during first 48 h postoperatively followed by slow or even no decline during the next 24 h. This rise preceded the day of operative confirmation by 3 ± 1.5 days, whereas the other two patients showed slow decline over first 72 h postoperatively. Seventy-eight patients had uneventful course, 18 patients had mild increase in IAP levels during first day followed by decline over next 2 days, whereas 60 patients had a decline in IAP levels during the first 72 h postoperatively. The specificity of the method was 76.9%, sensitivity 83.3%, negative predictive value 96.8%, positive predictive value 35.7%, with overall accuracy of 77.8%. This study supports the role of IAP as a relevant marker for deciding the need for relaparotomy, as a part of the on-demand approach.


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