| PRACTICE CHANGING CONTINUING EDUCATION: SURGICAL PRACTICE |
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| Year : 2014 | Volume
: 1
| Issue : 1 | Page : 28-32 |
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Abdominal compartment syndrome
Vijayshil Gautam1, Mayur Narayan2
1 All India Institute of Medical Sciences, Patna, Bihar, India
2 R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
Correspondence Address:
Dr. Vijayshil Gautam
POB 200, Potters Bar, EN6 1XJ, Herts, UK
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2349-0977.131859
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Despite being a recognized clinical entity for past more than 100 years, Abdominal Compartment Syndrome (ACS) continues to be an ill understood and under diagnosed condition in surgical practice. It has a high prevalence of upto 50 percent in general surgical or trauma patients receiving intensive care and is associated with twice the death rate. Concurrent medical conditions such as diabetes, ascites, heart failure and a host of others increase the vulnerability both in terms of development of ACS and a poorer outcome. It is also a major cause of death in trauma. Since ACS often clinically mimics the underlying condition, such as abdominal injury or peritonitis/ ascites from any cause, its presentation is confusing. Diagnosis is based on clinical awareness of its potential risk, simple bedside intra-abdominal pressure (IAP) measurement, repeated examination of the abdomen and a 24 × 7 vigil on vital signs. Biochemical markers are non-specific and unreliable. Treatment is very urgent and may involve achieving permissive hypotension, careful management of fluid balance, high quality intensive medical and nursing care, prevention/treatment of sepsis, abdominal drainage and if indicated, decompression surgery by laparotomy, leaving the abdomen open and protected with sterile dressings or a temporary abdominal negative pressure therapy device. Prompt, good and urgent care reduces the risk of adverse outcome. |
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