الفهرس 
PATIENT AND METHODSOnly 14 pages are availabe for public view
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Abstract
This prospective study was designed to evaluate the role of intra-abdominal
pressure (IAP) measurement during the early postoperative period as an
independent factor of the need for re-exploration. Urinary output was
observed and its relation with intraabdominal hypertension IAH was
studied. The significance of clinical abdominal examination as an indicator
of raised IAP was assessed. The study comprised 50 patients; 35 (70%)
males and 15 (30%) females, 35 (70%) Egyptian, 10 (20%) British and 5
(10%) Asian, with mean age 48±18 years.
All patients were assigned to undergo exploratory laparotomy for acute
abdomen for various indications. Each patient underwent single
preoperative and eight-hourly postoperative serial IAP measurements for a
period of 72 hours via two-ways indwelling Foley’s catheter. 5 patients
underwent relaparotomy had significant increase (from 10.9±1.2 to
18.4±1.5 mmHg) in IAP during 1st 48 hours postoperatively followed by
slow or even no decline during the next 24 hours, 44 patients had uneventful
course.
The specificity of the method was 79.5%, sensitivity 83.3%, negative
predictive value 97.2% positive predictive value 35.7%, and accuracy
80.0%.
The 5 patients who underwent relaparotomy had developed low urinary
output of 18-24 ml/hr with normal blood pressure. IAP measurement ranged
from 11 to 16 mmHg in these patients. Non developed anuria.
The sensitivity of abdominal examination with the measured bladder
pressure more than 15 mmHg was 66.6%, specificity 88.8%, positive
predictive value 40.0%, negative predictive value 96.0% and accuracy
86.6%.
This study supports the role of IAP measurement as a relevant marker of
deciding the need for relaparotomy. Moderate elevations in IAP were
associated with decline in urine output was confirmed in this series.