BACKGROUND: Severely injured @entity1 have been observed to acutely develop @entity843 ; however, the pathogenesis of this rare phenomenon is poorly understood. OBJECTIVES: To report the factors common among severely injured @entity1 developing @entity843 and to formulate a hypothesis regarding its origin. METHODS: Retrospective review of case series. RESULTS: We identified 9 injured @entity1 between January 1, 1993, and December 31, 1998, who acutely developed significant amounts of @entity843 . The mean +/- SD estimated @entity843 volume was 2.0 +/- 0.8 L. All 9 @entity1 had severe @entity1457 and were mechanically ventilated before abdominal decompression for the @entity8479 . The mean +/- SD peak inspiratory pressure was 39.0 +/- 5.8 cm @entity2507 . The mean +/- SD volumes of crystalloid and blood product infusion before decompression were 16.1 +/- 10.2 L and 5.2 +/- 4.8 L, respectively, in a mean +/- SD of 17 +/- 15 hours. In comparison, the mean +/- SD volumes of crystalloid and blood product transfusion among 100 contemporary, randomly selected @entity1 undergoing @entity130 laparotomy were 5.1 +/- 5.5 L and 1.1 +/- 2.5 L, respectively (P<.001). Eight @entity1 had only extra-abdominal injuries, while 1 @entity1 had a combination of extra- and intra-abdominal injuries. Two @entity1 were found to be cirrhotic by liver biopsy, but the other 7 @entity1 had no known preexisting @entity99 . Eight @entity1 had absorbable mesh temporary abdominal closure, and 1 @entity1 had primary fascial closure. There was persistent ascitic drainage in 5 @entity1 ; however, in all but 1 @entity1 with @entity82 , the drainage did not persist beyond 3 days. Two @entity1 died, 1 of @entity295 and the other of a closed @entity542 . CONCLUSIONS: Common denominators of posttraumatic @entity843 include @entity1457 , massive fluid resuscitation, and elevated intrathoracic pressure. The rapid onset of @entity843 in the setting of elevated intrathoracic pressure suggests that the @entity1 's ability to clear ascitic fluid is overwhelmed.

Mechanism of acute @entity843 formation after XXXX resuscitation.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity82 :: ('MESH:D005355', 'Disease') :: ['cirrhosis'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity1457 :: ('MESH:D012769', 'Disease') :: ['shock'] @entity843 :: ('MESH:D001201', 'Disease') :: ['ascites'] @entity542 :: ('MESH:D006259', 'Disease') :: ['head injury'] @entity8479 :: ('MESH:D059325', 'Disease') :: ['abdominal compartment syndrome'] @entity2507 :: ('CHEBI:33813', 'Chemical') :: ['H2O'] @entity99 :: ('MESH:D056486', 'Disease') :: ['hepatic disease'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity130 :: (MESH:D014947,Disease) :: ['trauma']
