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January 4, 1985

Oliguria and Increased Intra-abdominal Pressure

Author Affiliations

Stanford University School of Medicine Stanford, Calif

JAMA. 1985;253(1):39. doi:10.1001/jama.1985.03350250047008

To the Editor.—  Clinicians should be aware that acute rises in intra-abdominal pressure (IAP) after surgical procedures or from other abdominal processes may be associated with oliguria or even anuria in the absence of apparent intravascular volume depletion.

Report of a Case.—  A 58-year-old morbidly obese woman underwent a ventral abdominal herniorrhaphy and panniculectomy, which was complicated by persistent respiratory failure, sepsis, and gastrointestinal tract bleeding. Renal function remained good, with a serum creatinine level of 1.5 mg/dL. Gastrointestinal tract bleeding recurred, and the patient was taken to surgery, where oversewing of two duodenal ulcers was performed. A previously placed polypropylene mesh abdominal wall graft was removed during the procedure, and, thus, the abdominal tissues were difficult to appose on closing the incision. The patient was hemodynamically stable during surgery, and urine output was 100 to 150 mL/hr. However, postoperatively over a period of 12 hours, oliguria and then anuria