Abdominal compartment syndrome complicating peptic ulcer disease

Figures & data

Figure 1: An X-ray of the chest and abdomen (taken in the sitting position)

Figure 2: The chest X-ray after the operation

Table 1: The blood gas results

Blood gas results	22 July 2103 at 08h12	22 July 2013 at 09h15	22 July 2013 at 11h25^*
pH (7.35–7.45)	7.07	6.81	7.05
Carbon dioxide (24–30 mmol/L)	67.00	91.00	50.00
Sodium (135–145 mmol/L)	137.00	135.00	136.00
Potassium (3.5–5.0 mmol/L)	4.40	4.90	5.50
Calcium (2.1–2.6 mmol/L)	0.96	0.92	0.81
Glucose (3.9–5.6 mmol/L)	9.20	9.40	4.70
Lactate (0.5–2.2 mmol/L)	5.10	9.10	3.90
Bicarbonate (21–28 mmol/L)	19.40	14.50	12.00
Base excess	−12.30	−19.90	−16.60
Haemoglobin (g/dl)	18.00	13.60	13.90

* : after the operation

Table 2: The laboratory results

Blood test (normal range)	22 July 2014	30 July 2014
Na (136–145 mmol/l)	144 mmol/l	146 mmol/l
K (3.5–5.1 mmol/l)	5 mmol/l	3.3 mmol/l
Chloride (98–107 mmol/l)	105 mmol/l	110 mmol/l
Bicarbonate (23–29 mmol/l)	17 mmol/l	23 mmol/l
Anion gap (9–16 mmol/l)	27 mmol/l	16 mmol/l
Urea (2.1–71.0 mmol/l)	8.1 mmol/l	8.1 mmol/l
Creatinine (64–104 mmol/l)^*	152µmol/l	79 µmol/l
Glomerular filtration rate (56–84 ml/min/m^2)^*	46 ml/minute/1.73 m^2	> 60 seconds/l
Amylase (20–104 U/l)	75 U/l	-
C-reactive protein (0–5 mg/l)	0 mg/l	24 mg/l
White cell count (3–10 µmol/l)	12.35 µmol/l	14.35 µmol/l
Haemoglobin (14.3–18.3 g/dl)	18.6 g/dl	10.9 g/dl
Haematocrit (0.43–0.55)	0.61	0.33
Platelets (150–400 umol/L)	361 × 10^9/l	277 × 10^9/l
Institutional normalised ratio (1.8–2.0)	Failed to clot
Prothrombin time (<2 sec)	Failed to clot
Procalcitonin (0–4.1 pmol/L)	-	4.8 µg/l

* : There was significant improvement in renal function. The procalcitonin levels indicate the likelihood of systemic infection