A 75-year old
male patient was admitted with clinical features of tensioned ascites, dyspnea for the last two weeks. He
had a history of appendectomy four years previously. During the first 24 hours in the intensive care unit
(ICU) the patient required high volume of i/v infusion and vasopressors for correction of hypotension and
oliguria. Computed tomography revealed characteristic signs for pseudomyxoma peritonei. Grade III
Abdominal Compartment Syndrome (ACS) was detected by measuring the intra-abdominal pressure via
the bladder and the patient was scheduled for decompressive laparotomy. During decompressive
laparotomy surgical debulking, peritoneal stripping combined with intraoperative hyperthermic
intraperitoneal chemotherapy with 5-FU were performed. After surgical decompression the patient’s
condition improved, the postoperative period was uneventful. During a 14 month follow-up period the
patient was free of disease recurrence. To the best of our knowledge this is the first case of
pseudomyxoma peritonei (PMP) induced intraabdominal hypertension and ACS successfully treated by
surgical debulking, peritoneal stripping combined with intraoperative hyperthermic intraperitoneal
chemotherapy with 5-FU.