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Showing 3 results for Laparotomy
Intra-abdominal hypertension and abdominal compartment syndrome in the surgical intensive care unit of Imam Khomeini Hospital: a 12 months study
Shamimi K, Aminian A, Moazami F, Jalali M,
Volume 64, Issue 12 (11-2006)
Abstract
Background: Abdominal compartment syndrome (ACS) is a clinical entity that develops from progressive, acute increases in intra-abdominal pressure (IAP) and adversely affects all vital organ systems In this study, the development of intra-abdominal hypertension (IAH) and ACS in a surgical ICU population is described and examined.
Methods: Over a one-year period (2004), urinary bladder pressure (UBP) was measured prospectively in all surgical patients with abdominal problems admitted to the ICU of the Imam Hospital complex. UBP of >20 cm H2O indicated IAH. ACS was defined as the development of multiple organ dysfunction including peak airway pressure (PAP) >50 cm H2O, Horowitz quotient <150 torr or urine output <0.5 ml/kg/hr in the setting of IAH. Data were gathered on all patients with IAH and ACS.
Results: We evaluated some 353 patients, consisting of 165 elective laparatomies and 188 emergency cases, including 28 trauma patients. The incidence of IAH and ACS was 2 and 1 per cent (7 and 3 patients, respectively). The mean IAP of these seven patients was 29.8 cm H2O. No elevated IAP was observed after elective laparotomy (165 patients), nor in emergency cases with temporary abdominal wall closure (29 patients). APACHE II score, PAP and worst base deficit were significantly higher in patients with elevated IAP. None of the three patients with ACS underwent decompressive laparotomy. The mortality rate for patients with elevated IAP was 85%, significantly higher than the total study population.
Conclusion: IAH is a rare disease of the rarity of IAH, routine measurement of IAP is necessary only in high-risk patients. Prophylactic temporary abdominal wall closure may prevent IAH and ACS in high-risk patients. Patients with elevated IAP have dismal outcomes. Critical care practitioners should become familiar with different aspects of IAH and ACS, including decompressive laparotomy.
Isolated Fallopian Tube Torsion with Fimbrial Cyst in a Pregnant Woman: A case Report
Naser Piri, Salahedin Delshad, Maryam Aghaee,
Volume 80, Issue 10 (1-2023)
Abstract
Background: Among diseases causing acute lower abdominal pain in women, isolated fallopian tube torsion is a rare cause that occurs mainly in women of reproductive ages and if left untreated can lead to fertility problems. Immediate diagnosis and timely surgery are urgent and necessary to preserve the fertility of females. Successful pregnancy with simultaneous involvement of isolated fallopian tube torsion is one of the rare operations in the world.
Case Presentation: The reported case is a 37-year-old pregnant woman (Gravid 2, with 33-week gestational age) with nausea, vomiting and abdominal pain in August 2020 who presented to the Maryam Hospital in Karaj in August 2020. The patient was examined in the operating room under anesthesia, and pain in the right and lower abdomen was observed. There was no anorexia, and on examination, there was severe tenderness in the right lower quadrant (RLQ) area. There was no pain in other parts of the abdomen. Ultrasonography in the patient's tenderness showed an image of a tubular and cystic structure measuring 30×10 mm. In CBC test, leukocytosis with high PMN (Polymorphonuclear), (WBC: 11700 mm3 and Neutrophil: 78%) was observed. During laparotomy, isolated torsion of the right fallopian tube observed, half of which was cyanotic. Due to the confirmation of fimbriae necrosis during surgery, preservation of uterine tube integrity, fallopian tube detorsion, excision of cyanotic fimbriae and hemorrhagic cyst of fimbriae, intra-abdominal fluid suction and fimbriae repair performed. The patient discharged in good condition after two days and gave birth to a healthy baby at 38 weeks of gestation by cesarean section.
Conclusion: Isolated fallopian tube torsion should be considered as a potential differential diagnosis in patients that have acute lower abdominal pain in women of reproductive ages and even adolescents. Early diagnosis and early surgical intervention are critical to maintaining the fallopian tube and fertility in the future. Laparoscopy is one of the main diagnostic tools for assessing, management and maintenance isolated torsion of the fallopian tube.

Study of the relationship between acidosis and coagulation disorders in patients undergoing laparotomy admitted to the intensive care unit
Reza Baghbanian, Shirin Azizidoost , Kamran Mahmoodi , Mahbobeh Rashidi , Golshan Mirmomeni, Sina Ganji Nataj ,
Volume 82, Issue 12 (3-2025)
Abstract
Background: Coagulopathy is one of the most common causes of mortality in the intensive care unit. This study was designed and implemented to investigate the relationship between acidosis and coagulation disorders in patients undergoing laparotomy in the intensive care unit.
Methods: This retrospective study reviewed the files of 121 patients undergoing laparotomy in the intensive care unit of Imam Khomeini Hospital of Ahvaz during 2024. Demographic and clinical records and blood test results were extracted to measure parameters related to acidosis and coagulation tests. Then, the rates of coagulopathy, thrombocytopenia, acidosis, and patient outcome were calculated. The data obtained were analyzed using SPSS version 27 software.
Results: Most patients studied were male (72 (59.5%)) with a mean age of 54.18±21.1 years and a mean length of stay of 6.78±5.87 days. Hypertension (34 (28.1%)) was the most important comorbidity and peritonitis (54 (44.6%)) was the most important cause of hospitalization. The incidence rates of coagulopathy, thrombocytopenia, and acidosis were reported to be 29 (24%), 27 (22.3%) and 115 (95%), respectively. A total of 44 (36.5%) patients died during the study period. Although the rates of coagulopathy and thrombocytopenia were higher in patients with acidosis, these differences were not significant (P<0.05). The mortality rates among those without thrombocytopenia, mild, moderate, and severe thrombocytopenia were reported as 27 (28.7%), 4 (33.3%), 9 (81.1%), and 4 (100%), respectively, showing a significant difference (P=0.001). The mean pH in deceased patients was significantly lower than in others (0.13±7.19 vs. 0.88±7.25; P=0.005). The mortality rate in patients with coagulopathy was also significantly higher than in others (20 (69%) vs.24 (26.4%); P=0.000).
Conclusion: The incidence of acidosis and coagulation disorders in patients undergoing laparotomy and admitted to the intensive care unit is significant and is linked to poorer outcomes for these patients. However, acidosis was not found to be an independent risk factor for coagulation disorders in this population. Further research is necessary to confirm or refute these findings.

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