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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

A 25-Year-Old Woman With Acute Pancreatitis and Hypotension Refractory to Aggressive Fluid Resuscitation*

Wayne Tsuang, BS; Mark Pohlman, MD; Jesse Hall, MD, FCCP
Author and Funding Information

*From the Pritzker School of Medicine (Mr. Tsuang), University of Chicago, Chicago, IL; Section of Pulmonary and Critical Care Medicine (Drs. Pohlman and Hall), University of Chicago Medical Center, Chicago, IL.

Correspondence to: Jesse Hall, MD, Section Chief, Pulmonary and Critical Care Medicine, MC 6076, University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL 60637; e-mail: jhall@medicine.bsd.uchicago.edu



Chest. 2007;132(5):1702-1705. doi:10.1378/chest.07-0717
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Extract

A 25-year-old woman with type II diabetes and hypertension presented to the emergency department complaining of abdominal pain and nonbloody, nonbilious emesis for 1 day. She denied fevers, chills, or dysuria. Due to mental status changes, she required intubation and transfer to the medical ICU.

1De Waele, JJ, Hoste, E, Blot, SI, et al (2005) Intra-abdominal hypertension in patients with severe acute pancreatitis.Crit Care9,R452-R4572De Waele, JJ, Hoste, EA, Malbrain, ML Decompressive laparotomy for abdominal compartment syndrome: a critical analysis.Crit Care2006;10,R513Malbrain, ML, Cheatham, ML, Kirkpatrick, A, et al Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome.Intensive Care Med2006;32,1722-17324Malbrain, ML, Chiumello, D, Pelosi, P, et al Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study.Crit Care Med2005;33,315-3225Malbrain, ML, Deeren, D, De Potter, TJ Intra-abdominal hypertension in the critically ill: it is time to pay attention.Curr Opin Crit Care2005;11,156-1716Mayerle, J, Hlouschek, V, Lerch, MM Current management of acute pancreatitis.Nat Clin Pract Gastroenterol Hepatol2005;2,473-4837Oda, S, Hirasawa, H, Shiga, H, et al Management of intra-abdominal hypertension in patients with severe acute pancreatitis with continuous hemodiafiltration using a polymethyl methacrylate membrane hemofilter.Ther Apher Dial2005;9,355-3618Sugrue, M Abdominal compartment syndrome.Curr Opin Crit Care2005;11,333-3389Sun, ZX, Huang, HR, Zhou, H Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis.World J Gastroenterol2006;12,5068-507010Vegar-Brozovic, V, Stoic-Brezak, J Pathophysiology of abdominal compartment syndrome.Transplant Proc2006;38,833-835

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