Abdominal Compartment Syndrome(ACS) and Obstructive Uropathy responding to ureteral stents from Retroperitoneal Bleeding secondary to Lovenox(LMWH)

Abstract

INTRODUCTION: ACS exists when Intra-abdominal Hypertension(IAH) is associated with clinically observed organ dysfunction. ACS adversely affects multiple organ systems. Normal Intraabdominal pressure(IAP) is atmospheric or subatmospheric. Subclincial organ effects progress to overt clinically manifest organ dysfunction beginning with IAH > 10 mm Hg. Pre-renal effects and Direct Renal Parencymal compression are the mechanism of renal failure. Direct ureteral compression is not implicated in renal dysfunction even with IAP∼40mm Hg.(5) Lovenox(LMWH) is infrequently reported (<1%) to cause spontaneous retroperitoneal bleeding and rarely caused ACS(3).