Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage

<p>Abstract</p> <p>Background</p> <p>Acute pancreatitis leads to abdominal hypertension and compartment syndrome. Weeks after the episodes pancreatic fluids sometimes organize to pseudocysts, fluid collections by or in the gland.</p> <p>Aims of the present s...

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Main Authors: Papavramidis Theodossis S, Duros Vassilis, Michalopoulos Antonis, Papadopoulos Vassilis N, Paramythiotis Daniel, Harlaftis Nick
Format: Article
Language:English
Published: BMC 2009-06-01
Series:BMC Gastroenterology
Online Access:http://www.biomedcentral.com/1471-230X/9/42
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author Papavramidis Theodossis S
Duros Vassilis
Michalopoulos Antonis
Papadopoulos Vassilis N
Paramythiotis Daniel
Harlaftis Nick
author_facet Papavramidis Theodossis S
Duros Vassilis
Michalopoulos Antonis
Papadopoulos Vassilis N
Paramythiotis Daniel
Harlaftis Nick
author_sort Papavramidis Theodossis S
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Acute pancreatitis leads to abdominal hypertension and compartment syndrome. Weeks after the episodes pancreatic fluids sometimes organize to pseudocysts, fluid collections by or in the gland.</p> <p>Aims of the present study were to evaluate the intra-abdominal pressure (IAP) induced by large pancreatic pseudocysts and to examine the effect of their transcutaneous drainage on IAP.</p> <p>Methods</p> <p>Twenty seven patients with a pancreatic pseudocyst were included. Nine patients with pseudocysts greater than 1l (group A) had CT drainage and eighteen (volume less than 1l) were the control group. The measurements of group A were taken 6 hours before and every morning after the drainage, while for group B, two measurements were performed, one at the day of the initial CT and one 7 days after. Abdominal compliance (Cabd) was calculated. Data were analyzed using student's <it>t</it>-test.</p> <p>Results</p> <p>Baseline IAP for group A was 9.3 mmHg (S.D. 1.7 mmHg), while the first post-drainage day (PDD) IAP was 5.1 mmHg (S.D. 0.7 mmHg). The second PDD IAP was 5.6 mmHg (S.D. 0.8 mmHg), the third 6.4 mmH (S.D. 1.2 mmHg)g, the fourth 6.9 mmHg (S.D. 1.6 mmHg), the fifth 7.9 mmHg (S.D. 1.5 mmHg), the sixth 8.2 mmHg (S.D. 1.4 mmHg), and the seventh 8.2 mmHg (S.D. 1.5 mmHg). Group B had baseline IAP 8.0 mmHg (S.D. 1.2 mmHg) and final 8.2 mmHg (S.D. 1.4 mmHg). Cabd after drainage was 185.6 ml/mmHg (SD 47.5 ml/mmHg).</p> <p>IAP values were reduced between the baseline and all the post-drainage measurements in group A. IAPs seem to stabilize after the 5<sup>th </sup>post-drainage day. Baseline IAP was higher in group A than in group B, while the two values, at day 7, were equivalent.</p> <p>Conclusion</p> <p>The drainage of large pancreatic pseudocyst reduces IAP. Moreover, the IAP seems to rise shortly after the drainage again, but in a way that it remains inferior to the initial value. More chronic changes to the IAP are related to abdominal cavity's properties and have to be further studied.</p>
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spelling doaj.art-05ba198a6a7a4f2ca08a25da444137472022-12-21T19:03:11ZengBMCBMC Gastroenterology1471-230X2009-06-01914210.1186/1471-230X-9-42Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainagePapavramidis Theodossis SDuros VassilisMichalopoulos AntonisPapadopoulos Vassilis NParamythiotis DanielHarlaftis Nick<p>Abstract</p> <p>Background</p> <p>Acute pancreatitis leads to abdominal hypertension and compartment syndrome. Weeks after the episodes pancreatic fluids sometimes organize to pseudocysts, fluid collections by or in the gland.</p> <p>Aims of the present study were to evaluate the intra-abdominal pressure (IAP) induced by large pancreatic pseudocysts and to examine the effect of their transcutaneous drainage on IAP.</p> <p>Methods</p> <p>Twenty seven patients with a pancreatic pseudocyst were included. Nine patients with pseudocysts greater than 1l (group A) had CT drainage and eighteen (volume less than 1l) were the control group. The measurements of group A were taken 6 hours before and every morning after the drainage, while for group B, two measurements were performed, one at the day of the initial CT and one 7 days after. Abdominal compliance (Cabd) was calculated. Data were analyzed using student's <it>t</it>-test.</p> <p>Results</p> <p>Baseline IAP for group A was 9.3 mmHg (S.D. 1.7 mmHg), while the first post-drainage day (PDD) IAP was 5.1 mmHg (S.D. 0.7 mmHg). The second PDD IAP was 5.6 mmHg (S.D. 0.8 mmHg), the third 6.4 mmH (S.D. 1.2 mmHg)g, the fourth 6.9 mmHg (S.D. 1.6 mmHg), the fifth 7.9 mmHg (S.D. 1.5 mmHg), the sixth 8.2 mmHg (S.D. 1.4 mmHg), and the seventh 8.2 mmHg (S.D. 1.5 mmHg). Group B had baseline IAP 8.0 mmHg (S.D. 1.2 mmHg) and final 8.2 mmHg (S.D. 1.4 mmHg). Cabd after drainage was 185.6 ml/mmHg (SD 47.5 ml/mmHg).</p> <p>IAP values were reduced between the baseline and all the post-drainage measurements in group A. IAPs seem to stabilize after the 5<sup>th </sup>post-drainage day. Baseline IAP was higher in group A than in group B, while the two values, at day 7, were equivalent.</p> <p>Conclusion</p> <p>The drainage of large pancreatic pseudocyst reduces IAP. Moreover, the IAP seems to rise shortly after the drainage again, but in a way that it remains inferior to the initial value. More chronic changes to the IAP are related to abdominal cavity's properties and have to be further studied.</p>http://www.biomedcentral.com/1471-230X/9/42
spellingShingle Papavramidis Theodossis S
Duros Vassilis
Michalopoulos Antonis
Papadopoulos Vassilis N
Paramythiotis Daniel
Harlaftis Nick
Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage
BMC Gastroenterology
title Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage
title_full Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage
title_fullStr Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage
title_full_unstemmed Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage
title_short Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage
title_sort intra abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage
url http://www.biomedcentral.com/1471-230X/9/42
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AT durosvassilis intraabdominalpressurealterationsafterlargepancreaticpseudocysttranscutaneousdrainage
AT michalopoulosantonis intraabdominalpressurealterationsafterlargepancreaticpseudocysttranscutaneousdrainage
AT papadopoulosvassilisn intraabdominalpressurealterationsafterlargepancreaticpseudocysttranscutaneousdrainage
AT paramythiotisdaniel intraabdominalpressurealterationsafterlargepancreaticpseudocysttranscutaneousdrainage
AT harlaftisnick intraabdominalpressurealterationsafterlargepancreaticpseudocysttranscutaneousdrainage