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. 2025 Jan 14;17(1):e77415.
doi: 10.7759/cureus.77415. eCollection 2025 Jan.

Prospective Study of Aetiopathogenesis and Monitoring of Intra-abdominal Pressure for Early Detection of Burst Abdomen

Gulab Dhar Yadav  1 , Anju Yadav  2 , Gajendra Pratap Singh  1
Affiliations

Prospective Study of Aetiopathogenesis and Monitoring of Intra-abdominal Pressure for Early Detection of Burst Abdomen

Gulab Dhar Yadav et al. Cureus. .

Abstract

Background: The risk of evisceration, the need for rapid treatment, and the possibility of recurrent dehiscence make burst abdomen a severe postoperative complication that surgeons must deal with. A wound's dehiscence is linked to severe morbidity and mortality. This study examined how rapidly abdominal burst and wound dehiscence could be identified in patients after both emergency and scheduled laparotomies.

Methods: This prospective study included 80 patients with burst abdomens, aged more than 18, who underwent exploratory laparotomies in the Department of General Surgery, LLR, and associated hospitals, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College from January 2021 to October 2022. Various factors were observed, such as postoperative wound infection, nutritional status, raised intra-abdominal pressure, type of pathology, and patients undergoing emergency or elective exploratory laparotomy.

Results: The presence of intra-abdominal sepsis (63.75%), anemia (61.25%), and hypoproteinemia (50%) favors a higher incidence of burst abdomen as preoperative risk factors. Among various pathologies, gastro-duodenal perforation (30.0%) was found to be the most common pathology associated with a burst abdomen. In the postoperative period, wound infection (77.5.0%) was the most common factor associated with a burst abdomen, followed by raised intra-abdominal pressure (due to cough (35%), vomiting (17.5%)), and postoperative abdominal distension (27.5%). Intra-abdominal pressure was found to be a very sensitive early predictor of wound dehiscence, with peak incidence on POD-6 (IAP>16 mmHg).

Conclusion: Emergency procedures are more likely than elective surgeries to result in a burst abdomen. Anemia and wound infection both raise the risk of abdominal rupture. Intra-abdominal pressure was found to be a very sensitive early predictor of wound dehiscence. In both the treatment and prevention of this disorder, adherence to good methods and serious attempts to reduce the influence of predisposing variables are much more important.

Keywords: elective laparotomy; wound dehiscence; burst abdomen; emergency laparotomy; intraabdominal pressure; risk-factors.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Ethics Committee Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur issued approval EC/240/Aug/2022. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Measurement of intra abdominal pressure using traditional foley's catheterisation method.
Figure 2
Figure 2. Intra abdominal pressure of 16 cm of water in a post operative patient of exploratory laparotomy.
Figure 3
Figure 3. Pathological findings seen in patients intra operatively.
Figure 4
Figure 4. Factors associated in postoperative period.
Figure 5
Figure 5. Incidence of burst abdomen on various post operative days at different intra abdominal pressure.
Post op day 4: postoperative day 4; Post op day 6: postoperative day 6; Post op day 8: postoperative day 8; IAP: intra-abdominal pressure.
See this image and copyright information in PMC

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