MANAGEMENT OF FROZEN ABDOMEN AFTER HYSTERECTOMY - CASE REPORT
Keywords:
frozen abdomen, hysterectomy, vacuum pack, open abdomenAbstract
Introduction: Frozen abdomen is characterized by the persistent loss of natural free spaces between intra-abdominal organs and compartmental structures, as well as pathological changes that are outof normal anatomical proportion. These pathological changes are brought on by a severe adhesive syndrome, followed by fibrotic and scar tissue formation.
Case report: A 56-year-old patient was admitted to the Intensive Care Unit with clinical signs of ileus. The patient had undergone a hysterectomy 28 days ago. The patient presented with abdominal pain, vomiting, and nausea. Laboratory tests and CT scans were obtained. After the performed tests, an indication for surgical treatment was set.
Under general anesthesia, a median laparotomy was performed which revealed an extremely difficult entry into the abdominal cavity due to the presence of abundant adhesions from a previous operation. The wound was left open and a vacuum-assisted closure (VAC) device was applied for continuous wound drainage, while broad-spectrum antibiotics were empirically initiated. Following this intervention, during the patient’s hospital stay, five additional interventions were performed to change the vacuum pack until complete closure of the abdominal cavity and establishment of full continuity of the surgical wound, followed by an improvement in the patient's general condition.
Conclusion: For a patient who has undergone surgery revealing a hostile abdomen, open abdominal management should be considered based on the origin of the illness. This allows for sufficient control of the abdominal cavity, as well as the identification and treatment of the disease.
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