PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Case Report

Volume 6 Issue 1

Hypoalbuminaemia Linking Peritoneal Leakage following LUCS - A Case Report of Intraabdominal Collection with Sepsis

Abdulla Ubaid, Chishti Tanhar Bakth Choudhury*, Muhammad Afzal Ahmad, Maumoon Asim, Aishath Azna Ali and Ibrahim Adhil

December 18, 2024

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Abstract

A 37 year old educated lady with a BMI of 34 and history of (H/O) 7 days prior caesarean section, presented in ER of Indira Gandhi Memorial Hospital (IGMH), Maldives .She was comparatively well until the 2nd post operative day (POD) but then developed dyspepsia and discomfort and its gradually increasing and 5th day of operation, abdomen becomes distended with pain. Initial scanning reveals intra-abdominal mild to moderate collection with no obvious hemorrhage or luminal perforation. As hemodynamic status was static, it was treated conservatively, but for pain compile with Fever, distension and frequent hypoglycaemia came in sight thus she shifted for better management in tertiary centre (IGMH&DH) on 7th POD. Immediate base line screening reveals tender, distended abdomen , Fever, mild resp distress, severe hypoalbuminaemia with features of sepsis and intraabdominal thick collection, minimal pleural and pericardial effusion. Exploratory laparotomy through Mid midline incision performed and reveals foul smelling thick collection in multiple location of peritoneal cavity. Drainage and cleansing had been done with wide drain tube. Patient shifted in critical care unit with Albumin, antibiotics and other logistic cares. On the 10th POD, the patient was discharged with stable health parametres of life.

References

  1. Levitt DG and Levitt MD. “Human serum albumin homeostasis: a new look at the roes of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements”. Int J Gen Med 9 (2016): 229-55.
  2. Ballmer PE. “Causes and mechanisms of hypoalbuminaemia”. Clin Nutr 20.3 (2001): 271-3.
  3. Herz MG., et al. “Symptomatic maternal intraperito-neal meconium granulomata: Report of two cases”. Diagn Gynecol Obstet 4.2 (1982): 147-49.
  4. Christian J Wiedermann. “Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients”. Curr Med Res Opin 36.12 (2020): 1961-1973.
  5. Calder PC. “Immunonutrition in surgical and critically ill patients”. Br J Nutr 98(Suppl 1) (2007): S133-S139.
  6. Christian J Wiedermann. “Moderator Effect of Hypoalbuminaemia in Volume Resuscitation and plasma Expansion with intravenous Albumin solution”. Int J Mol Sci 23.22 (2022): 14175.
  7. Nestle Health science (2020) IMPACT Advance recovery 250 ml product details.
  8. Keller U. “Nutritional laboratory markers in malnutrition”. J clin Med 8.6 (2019): 775.
  9. Schwartz IS., et al. “Maternal vernix caseosa peritonitis following premature rupture of fetal membranes”. JAMA 254.7 (1985): 948-50.
  10. Stuart OA, Morris AR and Baber RJ. “Vernix caseosa peritonitis - no longer rare or innocent: A case series”. J Med Case Reports 3 (2009): 60.
  11. Wisanto E., et al. “A cheesy diagnosis”. Lancet 376.9740 (2010): 564.
  12. Myers JR and Fernando C. “Radiology of vernix caseosa peritonitis: Case report and discussion”. J Med Imaging Radiat Oncol 55 (2011): 301-3.