Abdominal Compartment Syndrome

Compartment syndrome occurs when pressures increase within a hard and fast cavity of the body, resulting in ischemia, muscle damage, and organ dysfunction. These "fixed" spaces are constrained by muscular and fascial boundaries, which may have limited compliance when they become swollen.[1][2][3]

Intra-abdominal hypertension is defined as the sustained intra-abdominal pressure (IAP) above 12 mmHg. 

Abdominal compartment syndrome (ACS) may be a severe illness seen in critically ill patients. ACS results from the progression of steady-state pressure within the abdomen to a repeated pathological elevation of pressure above (> 20mmHg) with associated organ dysfunction. Failure to recognize and immediately manage ACS can lend to poor prognosis as ACS is recognized as an independent predictor of mortality. High clinical suspicions with protocolized monitoring and management should be adapted when treating the critically ill, especially those with significant fluid shifts. This clinical diagnosis should be considered in patients with tense or distended abdomen with associated instability; however, it's going to even be seen without abdominal distention. 

The exact clinical conditions that outline ACS are controversial. The dysfunction may present with respiratory concerns such as high peak airway pressure and inadequate ventilation and oxygenation or decreased urine output caused by falling renal perfusion, but these concerns are reversible with intervention. 

Abdominal compartment syndrome has medical and conservative management options, and treatment is aimed toward identifying and treating the explanation for the compartment syndrome. However, patients with clinical deterioration may require emergent surgical decompression.

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