Intra-abdominal Pressure as a Criterion for Abdominal Re-exploration
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This prospective study was designed to evaluate the role of intra-abdominal pressure (1,413) measurement during the early postoperative period as a criterion of the need for re-exploration. The study comprised 90 patients; 60(66.7%) males and 30 (33.3%) females, with mean age 45.15±11.9. All patients were assigned to undergo exploratory laparotomy for acute abdomen for .various indications. Each patient underwent single preoperative and eight-hourly postoperative serial 1AP measurements for a period of 72 hours via two-ways indwelling Foley's catheter. 12 patients underwent relaparatomy, 10 had a significant increase in 1AP during 1st 48 hours postoperatively followed by slow or even no decline during the next 24hours. This rise preceded the day of operative confirmation by 3±1.5 days, whereas the other 2 patients showed slow decline over 1st 72 hours postoperatively. 78 patients had uneventful course, 18 patients had mild increase in 1AP levels during 1st day followed by decline over next 2 days. Whereas, 60 patients had a decline in 1AP levels during the 1st 72 hours postoperatively. The specificity of the method was 76.9 %, sensitivity 83.3 %, negative predictive value 96.8 %, positive predictive value 35.7 %, with overall accuracy of 77.8 %. This study supports the role of 1AP as a relevant marker for deciding the need for relaparotomy, as a part of the on-demand approach.