{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T04:03:28Z","timestamp":1769313808235,"version":"3.49.0"},"reference-count":36,"publisher":"Termedia Sp. z.o.o.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesiol Intensive Ther"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Without timely diagnosis, acute primary abdominal compartment syndrome (ACS) is a\u00a0potentially fatal syndrome and often goes unrecognized until severe symptoms appear. Early diagnosis may significantly improve the prognosis of these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We present the case of a\u00a054-year-old man, successfully treated for acute myeloid leukemia with cytosine arabinoside, admitted to the intensive care unit with severe shock, refractory to standard therapy with antibiotics, fluid resuscitation, and vasopressors. Early diagnosis of acute primary abdominal syndrome was made based on an intra-abdominal pressure of 20 mm Hg (3 kPa) with new onset organ failure, after which decompressive laparotomy was performed. Stool cultures grew Clostridium difficile. Despite abdominal decompression, the abdominal compartment syndrome persisted with the development of toxic megacolon and a\u00a0total colectomy was performed with favorable evolution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A\u00a0systematic review of published case reports was performed describing a\u00a0primary ACS due to C. difficile toxic megacolon. A\u00a0PubMed database search was performed with the following search terms, single or in combination: \u2018clostridium difficile\u2019, \u2018toxic megacolon\u2019, \u2018abdominal compartment syndrome\u2019, and \u2018CDI\u2019. The latest search was performed for March 2019; only case reports after 1998 were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found a\u00a0total of 19 case reports with C. difficile toxic megacolon (including the present case). The male\/female ratio was 12\/7, and there were 3 children. The mean age was 48.7 \u00b1 23.5 years. The reason for admission was sepsis in 6, trauma in 2, postoperative in 4, enterocolitis in 5, pregnancy in 1 and abdominal complaints after topical antibiotics in 1. Three patients did not develop diarrhea. Five patients presented with diarrhea on average 5.8 \u00b1 5.1 (median 4, 1\u201314) days prior to hospital admission while 7 patients developed diarrhea on average after 10 \u00b1 19.6 (median 3, 0\u201354) days during admission. The intra-abdominal pressure (measured in 6 patients, including ours) was 29.2 \u00b1 11 (20\u201350) mm Hg (3\u20137 kPa). Treatment consisted of (a\u00a0combination of) vancomycin (orally or via rectal enemas), metronidazole (orally or intravenously), and surgical intervention (with decompressive laparotomy). Three patients died (15.8%).<\/jats:p><\/jats:sec>","DOI":"10.5114\/ait.2019.89189","type":"journal-article","created":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T08:45:12Z","timestamp":1572943512000},"page":"273-282","source":"Crossref","is-referenced-by-count":2,"title":["Acute primary abdominal compartment syndrome due to Clostridium difficile induced toxic megacolon: a\u00a0case report and review of the literature"],"prefix":"10.5114","volume":"51","author":[{"given":"Tom","family":"Carmeliet","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Zach\u00e9e","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilde","family":"Dits","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels Van","family":"Regenmortel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manu L.N.G.","family":"Malbrain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3061","published-online":{"date-parts":[[2019,10,28]]},"reference":[{"key":"ref-1383772","doi-asserted-by":"crossref","unstructured":"Malbrain ML, Cheatham ML, Kirkpatrick A, et al. 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