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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2012 February;25(1):51-3
The silo using an infusion bag for ruptured abdominal aneurysm
Tamaki M., Tomita S., Kato T., Okawa Y.
Department of Cardiovascular Surgery, Gifu Heart Center, Gifu, Japan
A 64-year-old man was diagnosed with ruptured abdominal aortic aneurysm. When closing abdomen, we were concerned about abdominal compartment syndrome due to swelled guts. We used a 2-liter autoclaved plastic bag to create a “silo”. The bottom was cut off and sutured with 2-0 vicryl to abdominal wall. A surrounding was rapped with a drape to prevent leakage. After coming back to Intensive Care Unit, the silo was lifted from bedside poles with plastic ropes. An intrabladder pressure was monitored intermittently and the pressure was stable around 10 mmHg and gradually decreased day by day. We closed abdominal wall at 5 days postoperatively. He made satisfactory progress after the second operation, and discharged at 37 days after initial operation. The silo technique has been used for congenital abdominal problems and offers several benefits such that infusion bags are cheap and easy to be prepared. Suture lines covered with drapes are watertight not to lose ascites, resulting in controlling intravascular volume. The rate of infection is low, because the space of the silo is closed. We reported here for the first time to treat ruptured abdominal aortic aneurysm with the silo technique.