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. |
