Massive ascites-related intraabdominal hypertension in abdominal malignances / 中华普通外科杂志

ABSTRACT

Objective To study the effects of chronic intra-abdominal hypertension (IAH) on the functions of vital organs. Methods From January 2004 to January 2008, 30 chronic massive ascites related IAH patients were enrolled including 12 colonic cancer cases, 7 pancreatic cancer cases, and 11 gastric cancer cases. Control group included 30 cases of gastrointestinal carcinoma without ascites hence no IAH. The specific malignances in this group were colonic cancer in 15 cases, pancreatic cancer in 8 cases, and gastric cancer in 7 cases. Age, gender and cancer stage were matched between the two groups. Symptoms in digestive, respiratoy and circulatory system and liver and kidney functions were recorded and KPS scores were compared respectively. Results The symptoms of abdominal distention in chronic IAH group and control group were presented respectively by 15 cases(50%) and 5 cases (17%) (P < 0.01). Symptoms of heart-throb or hypotension in the two groups by 10 cases (33%) and 3 cases (10%) respectively(P<0.05). Symptoms of asthma or chest distress in the two groups by 9 cases(30% ) and 1 cases (3%) respectively (P< 0.01). Liver function were abnormal in 16 cases (53%) and 6 cases (20%) respectively (P < 0.01 ), kidney functions were abnormal in 14 cases (47%) and 1 case( 3% ) respectively ( P <0.01 ) . There were 22 cases (73 %) and 7 cases (23 %) respectively ( P < 0.01 ) in the two groups with KIS score being lower than 40. Conclusions Chronic IAH causes malfunctions of vital organs deteriorating patients general status and even leading to abdominal compartment syndrome.