Abdominal Compartment Syndrome Following Paraesophageal and Diaphragmatic Hernia Repair

TL;DR

This paper reports a rare case of abdominal compartment syndrome after hernia repair, highlighting the need for preventive measures in certain patients.

Contribution

The paper reports the first case of postoperative abdominal compartment syndrome following repair of paraesophageal and Morgagni diaphragmatic hernias.

Findings

Abdominal compartment syndrome can occur after laparoscopic repair of large paraesophageal hernias and Morgagni CDHs.

Prophylactic omentectomy may be considered to prevent this rare complication in select patients.

Abstract

Abdominal compartment syndrome (ACS) is defined as a sustained intra-abdominal pressure ≥ 20 mm Hg, associated with new organ dysfunction. Postoperative ACS can occur following repair of hernias with loss-of-domain. Such loss-of-domain hernias are well described involving incisional hernias, less described involving Bochdalek congenital diaphragmatic hernias (CDHs), but not yet described involving paraesophageal hernias (PEHs) or Morgagni CDHs. We describe a case of postoperative ACS following laparoscopic repair of a PEH and Morgagni CDH. This case demonstrates that prophylactic omentectomy should be considered in select patients undergoing repair of large PEHs or CDHs, as ACS is a rare but potential complication.

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