Volkmann's ischaemic contracture of the upper extremity - raising a red flag in the setting of developing countries.

INTRODUCTION: Volkmann's ischaemic contracture (VIC) is a disabling condition resulting from tissue necrosis due to impaired vascular supply to the limb. Over the years VIC has become rare in developed countries with many different aetiologies described. It was alarming to have high incidence of established VIC in our practice in Nepal. A detailed analysis was conducted to accurately describe this issue. METHODS: We collected 47 cases of VIC over six years and noted the age, sex, district of origin and cause of VIC, duration of injury to presentation, and the grade of VIC. Then we compared these characteristics of VIC of each Nepal province and created a map to show the problematic regions. RESULTS: Out of 47 patients, 46 could have been prevented by an early treatment. The most common cause was a tight cast in 25 patients (53.19%), followed by unintentionally self-caused VIC by applying tight bandages in 21 patients (44.68%). Most cases came from province 6 (29.78%). Our group included three mild (6.4%), 35 moderate (74.5%) and nine severe (19.1%) cases of VIC. Only 14 cases (29.78%) had a timely fasciotomy in the past. CONCLUSION: VIC is an irreversible complication of the compartment syndrome which is an easily preventable condition in the setting of developing countries. Our focus should, therefore, aim at preventing such disastrous conditions as 97.87% of cases we encountered could have been avoided by proper primary care. In the case of Nepal most cases came from province 6 and province 3.

Non-fracture acute compartment syndrome in the upper extremity of a 14-year-old boy: A case report and review of the literature.

INTRODUCTION: Acute compartment syndrome (ACS) is an orthopaedic emergency affecting all age groups, yet diagnosis proves particularly difficult within the paediatric population and especially in the absence of fractures. CASE PRESENTATION: In this case report, we detail a rare instance of a non-fracture acute compartment syndrome (NFACS) in a 14-year-old boy, initially missed due to lack of suspicion. Symptoms included swelling, severe pain, and initial paresthesia in the hand. Despite prompt forearm fasciotomy, severe post-traumatic Volkmann contracture ensued, resulting in limited upper extremity function despite multiple corrective surgeries. CLINICAL DISCUSSION: Acute compart syndromes, occurring without fractures, often faces delayed diagnosis, particularly in paediatrics population. Clinical examination remains the diagnostic gold standard, with analgesia refractory pain warranting suspicion. Additional diagnostic criteria like ultrasound, MRI or CK blood values can be evaluated with reservation, especially in the paediatric population. CONCLUSION: This case highlights the importance of increased vigilance in diagnostics for NFACS especially in children, in order to not overlook NFACS, due to the wide variability in the aetiology and clinical appearance. We emphasize the relevance of clinical diagnostics and point out an increased awareness of NFACS in analgesic refractory pain.

Short and long-term outcomes of multidimensional physiotherapy in cases with acute compartment syndrome secondary to carbon monoxide poisoning with prolonged forearm compression.

BACKGROUND: Compartment syndrome following carbon monoxide (CO) poisoning and compression, can have a devastating impact on neuromuscular structures, depending on a time-based dosage. PURPOSE: To investigate multidimensional physiotherapy's short-term and long-term outcomes in identical twin cases who developed compartment syndrome due to CO poisoning and prolonged compression. STUDY DESIGN: Case report. METHODS: This study was conducted with two male cases, a 21-year-old identical twin. The loss of consciousness due to CO poisoning lasted for 15 hours. Case one had compartment syndrome that caused damage to the median and ulnar nerves in the right forearm, while Case two had compartment syndrome that caused damage to the radial nerve in the left forearm. No surgical intervention was performed (Fasciotomy etc). RESULTS: The disability, dexterity, hand health status, sensory-motor function, and edema were evaluated. Initial evaluations showed severe sensory and motor dysfunction, disability, and edema. Treatment included Complex decongestive physiotherapy, electrical stimulation, therapeutic ultrasound, orthotics, and exercises. On the 144th day (discharge day), both cases still exhibited weakness in functional strength and sensory loss compared to the uninjured side. At the ninth month, all parameters except strength were similar to the uninjured side in both cases. By the 53rd month, strength also reached normal values. CONCLUSIONS: Multidimensional physiotherapy effectively manages edema, improves sensory-motor function, and enhances hand function in the short and long term.

Compartment syndrome associations with drugs: a pharmacovigilance study of the FDA adverse event reporting system (FAERS).

BACKGROUND: Compartment syndrome is an uncommon but life-threatening condition. No study has comprehensively compared compartment syndrome (CS) association with available drugs. The objective of this study was to estimate the association between CS and drugs using the FDA Adverse Event Report System (FAERS). RESEARCH DESIGN AND METHODS: FAERS reports from the first quarter of 2004 to the third quarter of 2023 were analyzed. The Medical Dictionary for Regulatory Activities (MedDRA) was used to identify CS cases. Reporting odds ratio (ROR), corresponding to 95% confidence intervals (95% CI) were calculated to detect a positive signal. RESULTS: A total of 2197 reports were considered in the study after the inclusion criteria were applied. Totally 100 drugs were found to be associated with CS. The median time for drug-associated CS was 45 days. CONCLUSIONS: By analyzing the FAERS database, the study revealed that certain drugs are significantly associated with compartment syndrome. Further studies are needed to verify whether these drugs are associated with such a risk.

Analysis of compartment syndromes in lower extremity pediatric and adolescent trauma - are there predictors of a late onset?

INTRODUCTION: Purpose of the study was to answer the question, if there are common fracture or injury characteristics, which help to identify patient at risk for a secondary compartment syndrome. MATERIALS AND METHODS: Between 2003 and 2022 all children and adolescents who were treated for a traumatic compartment syndrome in a lower extremity were retrospectively evaluated. Patient's demographics were recorded, the underlying trauma mechanism identified. Fractures were classified, treatment and complications were analyzed. We differentiated two groups of patients (early onset vs. late onset) and compared trauma mechanism, fracture location, classification and treatment between those two entities. RESULTS: Our collective consisted of 56 children and adolescents with 67 compartment syndromes, with an average age of 14.1 years (5-17). 41 (73.2 %) of the patients were male and 15 (26.8 %) female. Most people in our sample had previously been involved in traffic accidents (64.3 %), with the most common mechanism of injury being "motorbike accident" (34.3 %) and "pedestrian/cyclist accident against car" (26.9 %). There was an accumulation of fractures of the lower leg, in particular tibial shaft fractures (AO 42 and 43A; 49.3 %). In our survey, dislocated fractures and fractures of the foot always led to an early onset of compartment syndrome. The tibial shaft fracture and the surgical treatment with intramedullary nailing showed a significant frequency in the late onset group. CONCLUSIONS: Special attention should be paid to pediatric and adolescent patients with tibial shaft fracture and surgical treatment with intramedullary nailing in order to detect and treat a possible late onset of a compartment syndrome at an early stage.

Subclavian line infiltration causing neck compartment syndrome and bradycardic arrest: A case report.

Unrecognized central venous catheter (CVC) infiltration is an uncommon but potentially life-threatening complication. For instance, a malpositioned subclavian line can infuse into the mediastinum, pleural cavity, or interstitial space of the neck. We present the case of a 30-year-old male with gunshot wounds to the right chest, resuscitated with an initially functional left subclavian CVC, which later infiltrated into the neck causing compression of the carotid sinus and consequent bradycardic arrest. Return of spontaneous circulation (ROSC) was achieved following intravenous epinephrine, cardiac massage, and emergency neck exploration and cervical fasciotomy. Our case highlights the importance of frequent reassessment of lines, especially those placed during fast-paced, high-intensity clinical situations. We recommend being mindful when using rapid transfusion devices as an interstitial catheter may not mount enough back pressure to trigger the system's alarm before significant tissue damage or compartment syndrome occurs.

Hepatic compartment syndrome, a rare complication after any liver insult or liver transplantation: Three case reports and literature review.

Hepatic compartment syndrome (HCS) is a rare but life-threatening entity that consists of a decreased portal flow due to intraparenchymal hypertension secondary to subcapsular liver hematoma. Lethal liver failure can be observed. We report three cases, and review the literature. A 54-year-old male was admitted for extensive hepatic subcapsular hematoma after blunt abdominal trauma. Initially, he underwent embolization of the hepatic artery's right branch, after which he presented clinical deterioration, major cytolysis (310 times the upper limit of normal [ULN]), and liver failure with a prothrombin time (PT) at 31.0%. A 56-year-old male underwent liver transplantation for acute alcoholic hepatitis. On postoperative day 2, he presented a hemorrhagic shock associated with deterioration of liver function (cytolysis 21 ULN, PT 39.0%) due to extensive hepatic subcapsular hematoma. A 59-year-old male presented a hepatic subcapsular hematoma five days after a cholecystectomy, revealed by abdominal pain with liver dysfunction (cytolysis 10 ULN, PT 63.0%). All patients ultimately underwent urgent surgery for liver capsule excision, hematoma evacuation, and liver packing, if needed. The international literature was screened for this entity. These three patients' outcomes were favorable, and all were alive at postoperative day 90. The literature review found 15 reported cases. HCS can occur after any direct or indirect liver trauma. Surgical decompression is the main treatment, and there is probably no place for arterial embolization, which may increase the risk of liver necrosis. A 13.3% mortality rate is reported. HCS is a rare complication of subcapsular liver hematoma that compresses the liver parenchyma, and leads to liver failure. Urgent surgical decompression is needed.

Regional anesthesia is safe for use in intramedullary nailing of low-energy tibial shaft fractures.

PURPOSE: The purpose was to compare perioperative outcomes of patients who underwent general or regional anesthesia for intramedullary (IM) nailing of tibial shaft fractures (TSFs). METHODS: Retrospective chart review was performed on a consecutive series of low-energy TSF patients who presented to a single academic medical center and a level 1 trauma center who underwent operative repair with a reamed IM nail. Collected information included demographics, injury information, anesthesia type (general or regional i.e. peripheral nerve block), intra-operative opiate consumption (converted to morphine milliequivalents [MME], and post-operative pain visual-analog scale [VAS] pain scores. Patients were divided into 3 groups based on the type of anesthesia received and univariate analysis was performed to compare the 3 groups. RESULTS: Seventy-six patients were included, with an average age of 44.47±16.0 years. There were 38 (50 %) who were administered general anesthesia and 38 (50 %) who were administered regional anesthesia in the form of a peripheral nerve block. There were no differences between the groups with respect to demographics, medical co-morbidities, rate of open fractures or AO/OTA fracture classification. Regional anesthesia patients received less intra-operative MME than general anesthesia patients (17.57±10.6, 28.96±13.8, p < 0.001). Patients who received regional anesthesia also spent less time in the operating room, received less MME on post-operative day 1, and ambulated further on post-operative day 1, however none of these differences were statistically significant. There were no cases of missed post-operative compartment syndrome or complications related to the administration of the peripheral nerve block. CONCLUSIONS: Regional anesthesia in TSF surgery received less intra-operative opioid requirements, without any untoward effects. LEVEL OF EVIDENCE: Therapeutic Level III.

Primary closure of fasciotomies has a reduced complication rate following compartment syndrome in the paediatric population.

PURPOSE: Currently no guidance exists within the literature regarding diagnostic criteria or the long-term outcomes for paediatric patients with acute compartment syndrome (ACS). We conducted a retrospective cohort study reviewing all cases of paediatric ACS managed at a single tertiary referral centre with the aim of characterising the factors responsible for the eventual outcomes. METHODS: The patient cohort was identified retrospectively by interrogating the hospital coding system for all paediatric patients between January 2014 and November 2022. The electronic emergency department, inpatient and operative notes as well as clinic letters for each patient were reviewed and data collected regarding presentation, associated injuries, management and subsequent complications plus length of follow-up. The data was analysed to determine if differences in presentation or management affected long term outcome. RESULTS: The final cohort consisted of 34 patients with a mean age of ten years at the time of presentation. The mean time from presentation to fasciotomy was 27.6 h (range 3.0 - 66.6). There was an overall complication rate of 37.5% with a mean follow-up period of 21 months. Patients who had direct closure of their fasciotomy wounds had a significantly lower complications rate and fewer operations compared to those who healed via other wound coverage methods or secondary intention (p < 0.05). CONCLUSIONS: Significantly higher complication rates were observed in patients who were unable to have direct wound closure following emergency fasciotomy. This information may be utilised to rationalise long term treatment plans and in counselling of patients and parents.

Acute Compartment Syndrome Following Reduction of Simple Elbow Dislocation.

Although rare, acute compartment syndrome may develop as a simple elbow dislocation after reduction without initial motor, sensory, or peripheral circulatory abnormalities. This report describes a rare case of this condition. Acute compartment syndrome remains a potential complication, even in a simple elbow dislocation without apparent initial abnormalities, and should be explained to patients. A peripheral nerve block during reduction may mask symptoms and delay recognition of acute compartment syndrome. This case highlights the importance of vigilant monitoring for acute compartment syndrome following reduction of simple elbow dislocations, especially when a peripheral nerve block is used during reduction.

Heroin Overdose Complicated by Compartment Syndrome, Rhabdomyolysis, and Acute Renal Failure.

The opioid-abuse epidemic is a problem that continues to persist world-wide. As such, appropriately evaluating and treating such patients is crucial, especially when considering the various complications that may arise. In rare cases, opioid overdoses can be complicated by compartment syndrome, rhabdomyolysis, and acute renal failure. All three of these complications can result in life threatening emergencies. We present a case of a 38-year-old male who was brought to the emergency department after reportedly being found lying on the ground for an unknown period of time from suspected heroin overdose. He was initially treated with 2 milligrams (mg) of intramuscular naloxone en route via emergency medical services with appropriate response. Shortly after arrival to the emergency department, the patient complained of severe right lower extremity pain, paresthesia and paralysis. Patient developed acute lower extremity compartment syndrome that was further complicated by rhabdomyolysis and acute renal failure. While emergency medicine physicians are familiar with the common complications of heroin overdose including mental status changes, respiratory depression and gastrointestinal symptoms, they must also be familiar with the less common ones. Notably, acute compartment syndrome. Compartment syndrome is ultimately a clinical diagnosis and warrants emergent surgical consultation. Every patient presenting to the emergency department warrants a complete, thorough physical examination to evaluate for any and all life-threatening conditions, regardless of the presenting complaint.

Upper Limb Compartment Syndrome-An Extremely Rare Life-Threatening Complication of Cutaneous Anthrax.

(1) Background: Cutaneous anthrax is a disease caused by a Gram-positive bacillus, spore-forming Bacillus anthracis (BA). Cutaneous anthrax accounts for 95% of all anthrax cases, with mortality between 10-40% in untreated forms. The most feared complication, which can be life-threatening and is rarely encountered and described in the literature, is compartment syndrome. (2) Methods: We report a series of six cases of cutaneous anthrax from the same endemic area. In two of the cases, the disease was complicated by compartment syndrome. The systematic review was conducted according to systematic review guidelines, and the PubMed, Google Scholar, and Web of Science databases were searched for publications from 1 January 2008 to 31 December 2023. The keywords used were: "cutaneous anthrax" and "compartment syndrome by cutaneous anthrax". (3) Results: For compartment syndrome, emergency surgical intervention for decompression was required, along with another three surgeries, with hospitalization between 21 and 23 days. In the systematic review, among the 37 articles, 29 did not contain cases focusing on compartment syndrome of the thoracic limb in cutaneous anthrax. The results were included in a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram. (4) Conclusions: Early recognition of the characteristic cutaneous lesions and compartment syndrome with early initiation of antibiotics and urgent surgical treatment is the lifesaving solution.

Validation of continuous intraabdominal pressure measurement: feasibility and accuracy assessment using a capsular device in in-vivo studies.

BACKGROUND: Monitoring Intraabdominal Pressure (IAP) is essential in critical care, as elevated IAP can lead to severe complications, including Abdominal Compartment Syndrome (ACS). Advances in technology, such as digital capsules, have opened new avenues for measuring IAP non-invasively. This study assesses the feasibility and effectiveness of using a capsular device for IAP measurement in an animal model. METHOD: In our controlled experiment, we anesthetized pigs and simulated elevated IAP conditions by infusing CO2 into the peritoneal cavity. We compared IAP measurements obtained from three different methods: an intravesical catheter (IAPivp), a capsular device (IAPdot), and a direct peritoneal catheter (IAPdir). The data from these methods were analyzed to evaluate agreement and accuracy. RESULTS: The capsular sensor (IAPdot) provided continuous and accurate detection of IAP over 144 h, with a total of 53,065,487 measurement triplets recorded. The correlation coefficient (R²) between IAPdot and IAPdir was excellent at 0.9241, demonstrating high agreement. Similarly, IAPivp and IAPdir showed strong correlation with an R² of 0.9168. CONCLUSION: The use of capsular sensors for continuous and accurate assessment of IAP marks a significant advancement in the field of critical care monitoring. The high correlation between measurements from different locations and methods underscores the potential of capsular devices to transform clinical practices by providing reliable, non-invasive IAP monitoring.

[Successful treatment of severe purulent peritonitis against the background of intraperitoneal hypertension syndrome (clinical case)]. / Uspeshnoe lechenie tyazhelogo gnoinogo peritonita na fone sindroma vnutribryushnoi gipertenzii (klinicheskii sluchai).

Traditional surgical treatment of widespread purulent peritonitis has some disadvantages that emphasizes the need for new approaches to postoperative care. The authors present successful treatment of diffuse purulent peritonitis using a combination of 'open abdomen' technology and VAC therapy. This approach reduces abdominal inflammation and intra-abdominal pressure. Combination of 'open abdomen' technology and VAC therapy provides effective control of inflammation and stabilization of patients with purulent peritonitis.

Risk factors for acute compartment syndrome in one thousand one hundred and forty seven diaphyseal tibia fractures.

PURPOSE: Acute compartment syndrome (ACS) remains a devastating complication of orthopaedic trauma. The tibial diaphysis is especially implicated in the development of ACS, both at the time of injury and after operative management. Identification of risk factors for ACS for these distinct scenarios has been investigated in a large cohort of patients. METHODS: This is a retrospective cohort study of all adults (age 18 years and older) presenting to a level 1 trauma centre with a diaphyseal tibia fracture. ACS was determined by a combination of clinical signs and symptoms and compartmental pressure monitoring. Potential risk factors were subject to univariate analysis with significant variables undergoing binary logistic regression analysis. RESULTS: 1147 tibial diaphyseal fractures over a twelve year period were studied. Age, multifragmented fracture pattern, male gender, high energy mechanism and intra- articular extension all showed a statistically significant association for ACS. Increasing body mass index (BMI) and treatment with an intramedullary nail favoured development of ACS post-operatively. CONCLUSION: Risk factors for the development of ACS specifically in tibial diaphyseal fractures have been highlighted. Patients managed with IMN or high BMI may warrant particular observation following operative intervention.

Low impact injury resulting in a Schenck type IV classified anterior knee dislocation as well as biceps femoris rupture: A Case Report.

Introduction: Dislocations of the knee joint represent very rare injuries in the literature, accounting for less than 0.02% of all musculoskeletal injuries. Case Report: This report describes a patient suffered a knee joint dislocation of the knee joint caused by a low impact injury following a stumbling trauma during volunteer of a sport competition. Anterior knee joint dislocation with incipient compartment syndrome was clinically prognosed. Vascular and nerve injuries were radiologically examined. Taken together the injury was classified as Schenck type IV CN, and surgical management of the current knowledge was pursued. A satisfying range of motion was examined during surgery next to solid vascular und nerve conditions post-surgery. Conclusion: In case of severe knee joint dislocations, the current standard of a closed reduction with subsequent diagnostic is recommended. Compartment syndrome, nerve, and vascular tears indicate emergency surgery.

Paralumbar compartment syndrome, a rare sequela of deadlifting: a case report and review of current literature.

BACKGROUND: Compartment syndrome is a well-known phenomenon that is most commonly reported in the extremities. However, paralumbar compartment syndrome is rarely described in available literature. The authors present a case of paralumbar compartment syndrome after high intensity deadlifting. CASE PRESENTATION: 53-year-old male who presented with progressively worsening low back pain and paresthesias one day after high-intensity deadlifting. Laboratory testing found the patient to be in rhabdomyolysis; he was admitted for intravenous fluid resuscitation and pain control. Orthopedics was consulted, and Magnetic Resonance Imaging revealed significant paravertebral edema and loss of muscle striation. Given the patient's lack of improvement with intravenous and oral pain control, clinical and radiographic findings, there was significant concern for acute paralumbar compartment syndrome. The patient subsequently underwent urgent fasciotomy of bilateral paralumbar musculature with delayed closure. CONCLUSION: Given the paucity of literature on paralumbar compartment syndrome, the authors' goal is to promote awareness of the diagnosis, as it should be included in the differential diagnosis of intractable back pain after high exertional exercise. The current literature suggests that operative cases of paralumbar compartment syndromes have a higher rate of return to pre-operative function compared to those treated non-operatively. This case report further supports this notion. The authors recommend further study into this phenomenon, given its potential to result in persistent chronic exertional pain and irreversible tissue damage.

Resolution of Confusion Over Compartment Syndrome After Tibial Osteotomy With Continuous Pressure Measurements.

Compartment syndrome (CS) can occur in a variety of clinical scenarios. Reperfusion injury and tissue swelling are common causes across etiologies. Trauma is recognized as a common cause, but CS is also seen after limb alignment correction for extremities. CS is a difficult diagnosis to make in any scenario. Timely diagnosis is also difficult. Correct diagnosis is inexact, with many false positives and some false negatives being the normal outcome. This case represents a scenario where it was inherently difficult to make the diagnosis. The patient was a young patient with an underlying neurodevelopmental disorder where physical and clinical examination was impossible to accomplish. Any intervention to decrease pain was also difficult and actively refused by the patient and the family. Leaving open wounds after a fasciotomy was also undesirable for wound care and infection. Previous care maps have high false-positive rates or a need for fasciotomy as the treatment arm when diagnosis is uncertain. This usually results in fasciotomy being performed in many legs without CS. These false positives and resultant prophylactic releases are costly because of protracted hospital stay, high rate of deep infection, and decreased operating room availability for other cases. The desirable tool for surgeons would be the one that decreased false positives and false negatives while ensuring diagnosis in a timely fashion for true-positive cases. Technology for monitoring continuous pressure has been shown to aid in diagnosis. In this report, we illustrate the use of a continuous pressure monitoring system in a case of a pediatric patient post-osteotomy of a lower limb presenting with unremitting pain and a difficult clinical examination.

A Rare Case of Aggressive Non-Hodgkin's Lymphoma of the Muscle in a Young Male Presenting as Necrotizing Myofasciitis.

Non-Hodgkin's lymphoma (NHL) involving skeletal muscle is generally found to be a secondary metastasis and extremely rarely as a primary site of malignancy. Furthermore, in HIV patients, an increased incidence of lymphomas may be identified within the first six months of highly active antiretroviral therapy (HAART) initiation unmasked by immune reconstitution inflammatory syndrome (IRIS). We illustrate an extremely rare instance of NHL of the skeletal muscle in a young immunocompromised male with HIV/AIDS presenting as necrotizing myofasciitis complicated by compartment syndrome and hemodialysis-refractory type B lactic acidosis. A young Hispanic male with AIDS was admitted for acute left thigh pain and was soon found to have abscess formation with compartment syndrome requiring thigh fasciotomy. During the course of the ICU stay, the patient's clinical status acutely worsened with sepsis-induced multiorgan failure, including acute renal and acute liver failure requiring N-acetylcysteine and severe refractory metabolic acidosis requiring renal replacement therapy. Repeat imaging demonstrated diffuse myonecrosis. Left thigh muscle biopsy confirmed aggressive NHL of skeletal muscle. Despite months of arduous medical management in ICU, doxorubicin, vincristine, cyclophosphamide chemotherapy with concurrent high-dose prednisone for the vented patient, and intermittent curves of improvement, our patient succumbed to the nature of the disease and subsequently died from severe sepsis from the immunocompromised state. Interestingly, our patient's initial CD4 count was 1, which improved to 96 after five months of HAART, raising concerns for IRIS lymphoma. Given such rapid improvement with chemotherapy, the possibility of IRIS-related lymphoma, and the surprising dearth of data for chemotherapy use in critically ill patients on mechanical ventilation, more research is needed in these topics to better approach such complicated patients.

An Analysis of the Impact of Intra-abdominal Pressure on Surgical Outcomes in Cases of Intestinal Obstruction: A Prospective Observational Study.

BACKGROUND: The decision and timing of surgical exploration of intestinal obstruction depend on the clinical findings and probable etiology of the symptoms. Patients with intestinal obstruction often have intra-abdominal hypertension (IAH), which is associated with a poor prognosis. PURPOSE OF THE STUDY: The purpose of the study is to evaluate the surgical outcomes in patients with intestinal obstruction in relation to intra-abdominal pressure (IAP). MATERIALS AND METHODS: The study was conducted on 50 patients with intestinal obstruction undergoing surgery. Preoperatively, IAP was measured in all the patients and was allocated into two groups based on the presence or absence of IAP. Patients were assessed for the postoperative length of hospital or ICU stay, surgical site infection, wound dehiscence, and recovery following surgery. RESULTS: The patients with preoperative IAH had significantly longer postoperative stays, with a median stay of eight days in these patients compared to four days in patients without IAH (p=0.009). A significantly higher number of patients (24%) had gangrenous changes on the bowel wall (p=0.042) and fascial dehiscence (p=0.018) in the group associated with raised IAP. A total of 75% of patients who required ventilator support belonged to the raised IAP group. The mean IAP in patients admitted to the ICU was significantly higher than in patients not admitted to the ICU (p=0.027). CONCLUSION: Preoperative IAH in intestinal obstruction is a significant factor in predicting the possibility of bowel ischemia with gangrene, perforation, intra-abdominal sepsis, surgical site infections, and prolonged hospital stay. Early surgical exploration and abdominal decompression must be considered in such cases.