The anesthesiologist was alerted to possible drop in pressure on opening the abdomen. Release of intraabdominal compression by distended bowel loops decreases venous return to the heart, compounding the contracted intravascular volume due to third space loss, and the hypotensive effects of anesthesia. Distended bowel loops were released slowly under control, and despite several liters of pre-op resuscitation, there was still a pressure drop requiring an additional 10 liters of fluid over the course of the procedure.
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