Case Report
Abdominal Compartment Syndrome After Hip Arthroscopy

https://doi.org/10.1016/j.arthro.2009.06.021Get rights and content

Abstract

As hip arthroscopy becomes a more common procedure, more complications may occur. We present a case of abdominal compartment syndrome resulting from fluid extravasation in a 42-year-old man who underwent routine hip arthroscopy for femoral acetabular impingement. He had not had previous surgeries to that hip, and arthroscopy was performed in the supine position. After adequate distraction, arthroscopy was performed with an automated pressure- and flow-controlled pump with the pressure maintained between 40 and 60 mm Hg. We performed debridement of a degenerative tear of the anterosuperior labrum, removal of a pincer lesion, and a psoas tenotomy through a capsular window. A distended abdomen was noted on drape removal, and the patient required decompressive laparotomy for abdominal compartment syndrome. Extravasation of arthroscopy fluid is a potentially devastating complication during hip arthroscopy, and there should be careful monitoring by the surgeons, anesthesiologists, and operating room staff.

Section snippets

Case Presentation

A 42-year-old man, an active-duty service member, with no significant medical or surgical history presented to our institution with a long-standing history of right hip and groin pain that was refractory to conservative management. He complained of pain while sitting and had difficulty putting on his boots. He also complained of intermittent audible snapping in his groin that was associated with pain. On physical examination, he had a positive impingement sign with pain in the flexed and

Discussion

This case of abdominal compartment syndrome is concerning. There are two previous reports of this complication, one of which occurred during elective surgery. Bartlett et al.2 reported this event after performing hip arthroscopy for loose-body removal in a patient who sustained an acetabular fracture of both columns and was treated with open reduction–internal fixation through an ilioinguinal approach. The fluid extravasation resulted in an intraoperative cardiac event and death. They concluded

References (9)

There are more references available in the full text version of this article.

Cited by (0)

The views and opinions expressed in this manuscript are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense, or the U.S. Government.

View full text
Published by Elsevier Inc.