abdominal compartment syndrome


abdominal compartment syndrome

a constellation consisting of cardiovascular, pulmonary, and renal compromise produced by increased intraabdominal pressure from bleeding (intraabdominal or retroperitoneal), ileus, peritonitis, or insufflation.

abdominal compartment syndrome

A compression (compartment) syndrome that results when extravasated blood and other fluids cause an abrupt increase in intra-abdominal pressure (IAP; formally, abdominal hypertension); chronically increased IAP, due to ascites and morbid obesity, are compensated for by increased abdominal wall compliance. Acutely increased IAP develops in surgical, ICU and other critical patients.
Intraperitoneal causes
Traumatic or post-operative hemorrhage, bowel distension, visceral oedema and peritonitis, laparoscopic procedures.
 
Retroperitoneal causes
Pancreatitis, traumatic retroperitoneal or pelvic sepsis or bleeding, sepsis.

abdominal compartment syndrome

Abbreviation: ACS
An extreme increase in pressure within the abdominal cavity that disrupts the blood flow to vital organs. It can result from any condition that causes an accumulation of blood or fluid within the abdominal space or a decrease in size of the abdominal cavity, including abdominal or pelvic trauma, intra-abdominal hemorrhage, peritonitis, extensive abdominal packing, and postoperative edema of the gastrointestinal tract.

Symptoms

Clinical manifestations of ACS include hypoxemia, widened pulse pressure, and a decrease in cardiac output, urinary output, level of consciousness, and gastric pH. Intra-abdominal pressure is normally less than 5 mm Hg. Signs of organ dysfunction occur when the pressure reaches 15 to 20 mm Hg, as measured indirectly by measuring bladder pressure.

Treatment

ACS is treated surgically. Patients require meticulous supportive care, e.g., of blood volume status, hemodynamics, oxygenation, and ventilation.

See also: compartment syndrome