| Abstract: Aims
Abdominal compartment syndrome is a recognised but insidious complication of acute abdominal conditions and is managed by staged laparotomy. We report the use of the Vacuum Assisted Closure (VAC) dressing system to treat an abdominal compartment syndrome complicated by enterocutaneous fistula.
Methods
A case of abdominal compartment syndrome following laparotomy for small bowel obstruction was managed with a VAC dressing at our hospital. Intra-abdominal pressures were measured via a urinary catheter. Subsequently the patient developed enterocutaneous fistulas, these were also managed with the VAC dressing. Literature supporting the use of the device in these conditions was reviewed.
Results
Relief of the compartment syndrome was achieved with the VAC dressing. Two enterocutaneous fistulas developed and were also managed with the VAC dressing, closing completely after 5 weeks. Abdominal wound closure also occurred and was documented with clinical photography.
Discussion
The VAC dressing is a new treatment for abdominal compartment syndrome and there is a growing literature supporting its use in laparostomy post trauma. Enterocutaneous fistula may be seen in patients following treatment of their abdominal compartment syndrome. There are five previously reported cases of enterocutaneous fistula management with the VAC dressing . Fistulas were previously a contraindication to the use of the VAC dressing however now such usage is approved .
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