With the exception of free peritoneal gas, mesenteric MDCT findings in bowel ischaemia are nonspecific, as they are commonly seen in any acute abdominal process [3].
Secondary abdominal compartment syndrome (ACS) is defined as widespread organ dysfunction in the respiratory, cardiac, renal, and gastrointestinal systems resulting from an increase in intraabdominal pressure that is not associated with a primary abdominal process [1].
Despite seemingly innocuous symptoms, many elderly patients with acute abdominal pain have serious pathology, including surgical disease and extra-abdominal processes manifesting with abdominal complaints.
Misdiagnosing a normal appendix as inflamed secondary to other intra-abdominal processes, such as Crohn's disease or pelvic inflammatory disease (false positive).
Table 2 Main diagnosis of the study cohort on admission Study cohort (n= 151) Cardiopulmonary diagnosis 67 (44.4) Acute/chronic liver failure 7 (4.6) Acute pancreatitis 5 (3.3) Gastrointestinal disease 8 (5.3) Other intra-abdominal processes 4 (2.6) Acute renal failure 13 (8.6) Cardiac arrest 5 (3.3) Neurologic disease 30 (19.9) Other 12 (8) Values are n (percent).
Strong support exists for an association between asbestos exposure and intra-abdominal processes such as peritoneal mesothelioma and ovarian carcinoma (Straif et al. 2009).
ACS was found after intra-abdominal processes (pancreatitis, ischemic colitis, and other) in 47% (11/23) of cases, after abdominal surgery or trauma in one-third (8/23), and in a minority (4/23) after other conditions (such as burns).
We found that prior daptomycin exposure, immunosuppression, or a concomitant gastrointestinal or intra-abdominal process, preceded the development of DNSE.
In addition, palliation is often difficult in the terminal stage, and death from a slow, obstructive, intra-abdominal process is not unusual.
