The secondary abdominal compartment syndrome
: not just another post-traumatic complication.
Even the ideal emergency resection procedure at the bedside--isolated segmental intestinal ischemia--foretold an 80% mortality rate which was closely followed by a 77.8% mortality rate for abdominal compartment syndrome
. Most likely, the low survivorship in this select group reflects the underlying comorbid conditions as well as the impact of the index cause for admission augmented by surgical stress.
Intra-abdominal hypertension and the abdominal compartment syndrome
: Updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome
We have presented a case of primary acute abdominal compartment syndrome
occurring intraoperatively, which was managed entirely through medical supportive treatment.
De Laet et al., "Intra-abdominal hypertension and abdominal compartment syndrome
in burns, obesity, pregnancy and general medicine," Anaesthiology Intensive Therapy, vol.
 If untreated, IAP rises and multiple organ failure begins, and may progress to abdominal compartment syndrome
(ACS), defined as a sustained IAP of 20 mmHg or higher and associated with new organ dysfunction.
Damage control surgery is one of the reasons for leaving an abdomen open initially.1 The abdominal wall defect can be due to leaving an abdominal incision open at the completion of surgery or by re-opening the abdomen for the reason of abdominal compartment syndrome
.2 Open abdomen exposes the viscera and leads to fluid, electrolyte and temperature loss, which can be reduced with temporary abdominal closure techniques until the abdomen can be closed secondarily, or graft/flap coverage provided.3
A recent review of 50 publications including 1 616 patients quoted prevalences of 64.7-74.5% for intra-abdominal hypertension and of 4.1-16.6% for abdominal compartment syndrome
. The mortality rate for abdominal compartment syndrome
in patients with severe burns was 74.8%.121 The development of compartment syndrome in burns patients is associated with total resuscitation volumes, and a reduction of the resuscitation volume in the Baxter (Parklands) formula from 4 to 3 ml/kg/% total body surface area has been proposed.
Malbrain, who directs intensive care and high care burn units in Belgium, and De Waele (Ghent U., Belgium) offer a guide to intra-abdominal hypertension and abdominal compartment syndrome
for all members of the intensive care team, including experienced and junior physicians, anesthetists, and nurses.
He said the procedure is used to manage complex abdominal wall defects that occur due to trauma, multiple reoperations, hernia, abdominal compartment syndrome
, obesity and other problems.