Journal of Surgery

Submit a Manuscript

Publishing with us to make your research visible to the widest possible audience.

Propose a Special Issue

Building a community of authors and readers to discuss the latest research and develop new ideas.

Case Report |

Abdominal Compartment Syndrome During Unilateral Biportal Endoscopic Spinal Surgery: A Case Report

Background: Abdominal compartment syndrome (ACS), a serious complication of organ failure, which is caused by acute and persistent increase of intra-abdominal pressure (IAP). Ascites is often ignored as a rare complication of unilateral biportal endoscopic (UBE) surgery. However, intra-abdominal hypertension (IAH) caused by massive ascites can lead to multiple organ dysfunction, which leads to the occurrence of ACS with a very high mortality rate. Case Presentation: In this case, the patient was a 74-year-old man who underwent UBE decompression for severe lumbar disc herniation. During the surgery, the airway pressure and stroke volume variation (SVV) were incerased gradually. when increasing saline pressure. Subsequently, the patient was diagnosed with ACS and treated with emergency diuretics and performing ultrasound-guided abdominal paracentesis to reduce abdominal pressure. After emergency treatment, the patient's IAH symptom was significantly relieved and his airway pressure and hemodynamics was rapidly improved. Conclusion: The possibility of ACS should be considered in the presence of persistently elevated airway pressure during UBE surgery. Without early diagnosis and timely management, ACS would have a high mortality rate. Considering the severity of ACS during surgery, we recommend taking measures to monitor intra-abdominal pressure during UBE surgery.

Unilateral Biportal Endoscopy, Abdominal Compartment Syndrome, Lumbar Disc Herniation, Ascites

APA Style

Luo, W., Ye, D. (2023). Abdominal Compartment Syndrome During Unilateral Biportal Endoscopic Spinal Surgery: A Case Report. Journal of Surgery, 11(6), 132-135.

ACS Style

Luo, W.; Ye, D. Abdominal Compartment Syndrome During Unilateral Biportal Endoscopic Spinal Surgery: A Case Report. J. Surg. 2023, 11(6), 132-135. doi: 10.11648/j.js.20231106.12

AMA Style

Luo W, Ye D. Abdominal Compartment Syndrome During Unilateral Biportal Endoscopic Spinal Surgery: A Case Report. J Surg. 2023;11(6):132-135. doi: 10.11648/j.js.20231106.12

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Zhu C, Cheng W, Wang D, Pan H, Zhang W (2022) A Helpful Third Portal for Unilateral Biportal Endoscopic Decompression in Patients with Cervical Spondylotic Myelopathy: A Technical Note. World Neurosurg 161: 75-81. doi: 10.1016/j.wneu.2022.02.021.
2. Jing X, Gong Z, Qiu X, Zhong Z, Ping Z, Hu Q (2022) "Cave-in" decompression under unilateral biportal endoscopy in a patient with upper thoracic ossification of posterior longitudinal ligament: Case report. Front Surg 9: 1030999. doi: 10.3389/fsurg.2022.1030999.
3. Park MK, Son SK, Park WW, Choi SH, Jung DY, Kim DH (2021) Unilateral Biportal Endoscopy for Decompression of Extraforaminal Stenosis at the Lumbosacral Junction: Surgical Techniques and Clinical Outcomes. Neurospine 18: 871-879. doi: 10.14245/ns.2142146.073.
4. Yuan C, Wen B, Lin H (2022) Clinical Analysis of Minimally Invasive Percutaneous Treatment of Severe Lumbar Disc Herniation with UBE Two-Channel Endoscopy and Foraminal Single-Channel Endoscopy Technique. Oxid Med Cell Longev 2022: 9264852. doi: 10.1155/2022/9264852.
5. Chen Z, Zhou H, Wang X, Liu Z, Liu W, Luo J (2023) Complications of Unilateral Biportal Endoscopic Spinal Surgery for Lumbar Spinal Stenosis: A Meta-Analysis and Systematic Review. World Neurosurg 170: e371-e379. doi: 10.1016/j.wneu.2022.11.019.
6. Kim W, Kim SK, Kang SS, Park HJ, Han S, Lee SC (2020) Pooled analysis of unsuccessful percutaneous biportal endoscopic surgery outcomes from a multi-institutional retrospective cohort of 797 cases. Acta Neurochir (Wien) 162: 279-287. doi: 10.1007/s00701-019-04162-2.
7. Rogers WK, Garcia L (2018) Intraabdominal Hypertension, Abdominal Compartment Syndrome, and the Open Abdomen. Chest 153: 238-250. doi: 10.1016/j.chest.2017.07.023.
8. Kirkpatrick AW, Roberts DJ, De Waele J, Jaeschke R, Malbrain ML, De Keulenaer B, Duchesne J, Bjorck M, Leppaniemi A, Ejike JC, Sugrue M, Cheatham M, Ivatury R, Ball CG, Reintam Blaser A, Regli A, Balogh ZJ, D'Amours S, Debergh D, Kaplan M, Kimball E, Olvera C (2013) Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med 39: 1190-1206. doi: 10.1007/s00134-013-2906-z.
9. Coccolini F, Roberts D, Ansaloni L, Ivatury R, Gamberini E, Kluger Y, Moore EE, Coimbra R, Kirkpatrick AW, Pereira BM, Montori G, Ceresoli M, Abu-Zidan FM, Sartelli M, Velmahos G, Fraga GP, Leppaniemi A, Tolonen M, Galante J, Razek T, Maier R, Bala M, Sakakushev B, Khokha V, Malbrain M, Agnoletti V, Peitzman A, Demetrashvili Z, Sugrue M, Di Saverio S, Martzi I, Soreide K, Biffl W, Ferrada P, Parry N, Montravers P, Melotti RM, Salvetti F, Valetti TM, Scalea T, Chiara O, Cimbanassi S, Kashuk JL, Larrea M, Hernandez JAM, Lin HF, Chirica M, Arvieux C, Bing C, Horer T, De Simone B, Masiakos P, Reva V, DeAngelis N, Kike K, Balogh ZJ, Fugazzola P, Tomasoni M, Latifi R, Naidoo N, Weber D, Handolin L, Inaba K, Hecker A, Kuo-Ching Y, Ordoñez CA, Rizoli S, Gomes CA, De Moya M, Wani I, Mefire AC, Boffard K, Napolitano L, Catena F (2018) The open abdomen in trauma and non-trauma patients: WSES guidelines. World J Emerg Surg 13: 7. doi: 10.1186/s13017-018-0167-4.
10. Rajasurya V, Surani S (2020) Abdominal compartment syndrome: Often overlooked conditions in medical intensive care units. World J Gastroenterol 26: 266-278. doi: 10.3748/wjg.v26.i3.266.
11. Li YS, Chen CM, Hsu CJ, Yao ZK (2022) Complications of Unilateral Biportal Endoscopic Lumbar Discectomy: A Systematic Review. World Neurosurg 168: 359-368. e352. doi: 10.1016/j.wneu.2022.10.038.
12. van Baal JO, Van de Vijver KK, Nieuwland R, van Noorden CJ, van Driel WJ, Sturk A, Kenter GG, Rikkert LG, Lok CA (2017) The histophysiology and pathophysiology of the peritoneum. Tissue Cell 49: 95-105. doi: 10.1016/j.tice.2016.11.004.
13. Malbrain ML, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, Balogh Z, Leppäniemi A, Olvera C, Ivatury R, D'Amours S, Wendon J, Hillman K, Johansson K, Kolkman K, Wilmer A (2006) Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Med 32: 1722-1732. doi: 10.1007/s00134-006-0349-5.
14. Cheatham ML (2009) Abdominal compartment syndrome: pathophysiology and definitions. Scand J Trauma Resusc Emerg Med 17: 10. doi: 10.1186/1757-7241-17-10.
15. Bailey J, Shapiro MJ (2000) Abdominal compartment syndrome. Crit Care 4: 23-29. doi: 10.1186/cc646.
16. Eddy V, Nunn C, Morris JA, Jr. (1997) Abdominal compartment syndrome. The Nashville experience. Surg Clin North Am 77: 801-812. doi: 10.1016/s0039-6109(05)70585-5.
17. Maluso P, Olson J, Sarani B (2016) Abdominal Compartment Hypertension and Abdominal Compartment Syndrome. Crit Care Clin 32: 213-222. doi: 10.1016/j.ccc.2015.12.001.
18. Nguyen J, Noory M, Capano-Wehrle L, Gaughan J, Hazelton JP (2018) Expeditious Diagnosis and Laparotomy for Patients with Acute Abdominal Compartment Syndrome May Improve Survival. Am Surg 84: 1836-1840.
19. Lewis M, Benjamin ER, Demetriades D (2021) Intra-abdominal hypertension and abdominal compartment syndrome. Curr Probl Surg 58: 100971. doi: 10.1016/j.cpsurg.2021.100971.
20. Spencer P, Kinsman L, Fuzzard K (2008) A critical care nurse's guide to intra abdominal hypertension and abdominal compartment syndrome. Aust Crit Care 21: 18-28. doi: 10.1016/j.aucc.2007.10.005.
21. De Waele JJ (2022) Intra-abdominal hypertension and abdominal compartment syndrome. Curr Opin Crit Care 28: 695-701. doi: 10.1097/mcc.0000000000000991.
22. Siebert M, Le Fouler A, Sitbon N, Cohen J, Abba J, Poupardin E (2021) Management of abdominal compartment syndrome in acute pancreatitis. J Visc Surg 158: 411-419. doi: 10.1016/j.jviscsurg.2021.01.001.
23. Padar M, Reintam Blaser A, Talving P, Lipping E, Starkopf J (2019) Abdominal Compartment Syndrome: Improving Outcomes With A Multidisciplinary Approach - A Narrative Review. J Multidiscip Healthc 12: 1061-1074. doi: 10.2147/jmdh.S205608.
24. Malbrain ML (2004) Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal. Intensive Care Med 30: 357-371. doi: 10.1007/s00134-003-2107-2.
25. Cheatham ML (2009) Nonoperative management of intraabdominal hypertension and abdominal compartment syndrome. World J Surg 33: 1116-1122. doi: 10.1007/s00268-009-0003-9.
26. Chen H, Li F, Sun JB, Jia JG (2008) Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage. World J Gastroenterol 14: 3541-3548. doi: 10.3748/wjg.14.3541.
27. Cheatham ML, Safcsak K (2011) Percutaneous catheter decompression in the treatment of elevated intraabdominal pressure. Chest 140: 1428-1435. doi: 10.1378/chest.10-2789.