Billiary pancreatitis leading to abdominal compartment syndrome treated with four Gore-Tex sheets

Submitted By: Dietmar Wittmann, MD, PhD, FACS
Year: 1998
Patient Age: 69
Number of STAR Entries: 7
Diagnoses: Pancreatitis, Abdominal Compartment Syndrome, Septic Shock, Intra-abdominal Infection, Sepsis, DIC...

The patient was a 69 year old woman with hypertension who presents with biliary pancreatitis which caused abdominal compartment syndrome necessitating abdominal decompression with 4 GORE-TEX sheets. At time of transfer her Appache-II score was 25 with a predicted mortality of 70%.

Decompressive laparotomy for peritonitis with abdominal compartment syndrome

Submitted By: Robert Behm, MD
Year: 2010
Patient Age: 69
Number of STAR Entries: 5
Diagnoses: Septic Shock, Sepsis, Dead Bowel, IA Abscess, Perforation, Colon Perforation, ACS, Ischemia

Patient History: 69-year-old female admitted to our facility after a seven-day history of abdominal pain associated with nausea, vomiting, and dehydration.

Colostomy takedown after repair of intestinal leaks

Submitted By: Dietmar Wittmann, MD, PhD, FACS
Year: 1993
Patient Age: 62
Number of STAR Entries: 11
Diagnoses: Abdominal Compartment Syndrome, Septic Shock, Anastomotic Leak, Intra-abdominal Infection, Colostomy...

This 62 year old man with macronodular liver cirrhosis developed diffuse peritonitis from an anastomotic leak following sigmoid colon resection. A colostomy had performed and the leak was sutured in an attempt to control peritonitis. The infection, however, continued due to continuous bacterial flow through a persistent anastomotic leak. On subsequent repair attempts the small bowel loops were perforated. The colostomy did not prevent peritonitis and the patient was transferred with multiple retention sutures cutting through the edges of a pararectal incision.

Large incarcerated umbilical hernia with small bowel, colon and gastric perforation

Submitted By: Jonathan Yunis, MD, FACS
Year: 2006
Patient Age: 53
Number of STAR Entries: 5
Diagnoses: Abdominal Compartment Syndrome, Gastric Perforation, Septic Shock, Intra-abdominal Infection, Sepsis...

The patient is a 53 year old morbidly obese (BMI 44) woman with a 3 year history of an untreated umbilical hernia which she routinely reduced herself until the day of presentation when she developed fever, chills, nausea and vomiting and was unable to reduce her hernia sack contents. She presents with a clinical picture of sepsis.

Blunt abdominal and closed cranial trauma with subdural hematoma

Submitted By: Dietmar Wittmann, MD, PhD, FACS
Year: 1988
Patient Age: 20
Number of STAR Entries: 6
Diagnoses: Abdominal Compartment Syndrome, Septic Shock, Intra-abdominal Infection, Sepsis, Acute Tubular Necrosis...

This 20 year old man was admitted unconscious with multiple trauma including blunt head and torso injury following a motor vehicle accident. Injury severity score (ISS)=24; Trauma score (TS) = 7. He was admitted to the neurosurgical ICU.

Chronic Open Abdomen With Fistula

Submitted By: Dietmar Wittmann, MD, PhD, FACS
Year: 1995
Patient Age: 63
Number of STAR Entries: 10
Diagnoses: Fistula, Diverticulitis, Hernia

Two years prior to transfer to our institution the patient underwent a Hartmann’s operation for diffuse peritonitis from perforated diverticular abscess of the sigmoid colon. Post operatively he required relaparotomy for persisting peritonitis with abdominal hypertension and the abdomen was left open. Once infection was controlled, multiple attempts to close the abdomen with various meshes failed and a bowel fistula developed.