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Refractory metabolic acidosis and acute abdominal compartment syndrome following Holmium Laser Enucleation of Prostate (HoLEP) Cover

Refractory metabolic acidosis and acute abdominal compartment syndrome following Holmium Laser Enucleation of Prostate (HoLEP)

Open Access
|Jul 2025

Figures & Tables

Fig. 1.

Timeline of Clinical Events in HoLEP Case. CTAP – Computed Tomography of Abdomen and Pelvis. SPC – Suprapubic Catheter.
Timeline of Clinical Events in HoLEP Case. CTAP – Computed Tomography of Abdomen and Pelvis. SPC – Suprapubic Catheter.

Fig. 2.

Comparison of Preoperative and Postoperative Chest X-rays in the patient with Abdominal Compartment Syndrome following HoLEP. The left image shows a normal preoperative chest X-ray, while the right image demonstrates postoperative abdominal distension and diaphragmatic splinting with reduced lung fields.
Comparison of Preoperative and Postoperative Chest X-rays in the patient with Abdominal Compartment Syndrome following HoLEP. The left image shows a normal preoperative chest X-ray, while the right image demonstrates postoperative abdominal distension and diaphragmatic splinting with reduced lung fields.

Fig. 3.

Abdominal CT done postoperatively on ICU admission showing fluid seepage into Extraperitoneal and Intraperitoneal Compartments. The left panel demonstrates intraperitoneal fluid (white arrow on the left) around the mesentery and bowel loops, while the right shows extraperitoneal fluid (white arrows on the right) in the retroperitoneal and perivesical spaces.
Abdominal CT done postoperatively on ICU admission showing fluid seepage into Extraperitoneal and Intraperitoneal Compartments. The left panel demonstrates intraperitoneal fluid (white arrow on the left) around the mesentery and bowel loops, while the right shows extraperitoneal fluid (white arrows on the right) in the retroperitoneal and perivesical spaces.

Arterial Blood Gas (ABG) Trends Demonstrating Severe Metabolic Acidosis Following HoLEP and Resolution Post-CRRT_

ABG parameterIntraopDay 0Day 1 AMDay 1 PMDay 2Day 3
FIO2 (%)10.50.30.30.30.21
pH7.1027.1417.2117.3987.4127.441
pCO2 (mmHg)42.237.635.935.835.633.9
pO2 (mmHg)278151.679.482.898.978.6
Base Excess (mEq/L)−16−15.6−12.8−2.8−2.1−1.2
Bicarbonate (mEq/L)13.212.714.520.622.623.4
Sodium (Na+, mEq/L)141136139138139139
Potassium (K+, mEq/L)4.36.04.54.03.93.5
Chloride (Cl, mEq/L)115115113109110105
Lactate (mmol/L) 3.33.24.82.71.7
Glucose (mmol/L)12.114.915.96.687.7
Anion Gap (mEq/L)12.88.311.58.46.410.6
DOI: https://doi.org/10.2478/jccm-2025-0027 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 301 - 306
Submitted on: Mar 12, 2025
Accepted on: Jun 18, 2025
Published on: Jul 31, 2025
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2025 Murugananth Nithiyananthan, Shitalkumar Sharad Shah, Aarthi Suhitharan, Suhitharan Thangavelautham, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.