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The abdominal compartment syndrome: CT findings
P J Pickhardt1, J S Shimony, J P Heiken
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
AJR. American Journal of Roentgenology
|September 2, 1999
Summary
Preoperative CT scans reveal key indicators of abdominal compartment syndrome (ACS), a dangerous condition caused by elevated intraabdominal pressure. Recognizing these signs is crucial for timely diagnosis and emergent treatment.
Area of Science:
- Radiology
- Surgical Pathology
- Critical Care Medicine
Background:
- Abdominal compartment syndrome (ACS) is a life-threatening condition characterized by elevated intraabdominal pressure.
- Early recognition and intervention are critical for patient survival.
Purpose of the Study:
- To identify characteristic findings on preoperative abdominal computed tomography (CT) scans in patients with proven abdominal compartment syndrome.
- To correlate CT findings with elevated intraabdominal pressure in ACS.
Main Methods:
- Retrospective review of preoperative abdominal CT scans from four patients diagnosed with abdominal compartment syndrome.
- Analysis of CT imaging for specific signs indicative of increased intraabdominal pressure.
Main Results:
- Consistent CT findings included tense retroperitoneal infiltration, extrinsic inferior vena cava compression, and massive abdominal distention (positive round belly sign, AP:Transverse ratio > 0.80).
- Additional findings in two patients each: renal compression/displacement, bowel wall thickening/enhancement, and bilateral inguinal herniation.
Conclusions:
- Specific CT findings can suggest abdominal compartment syndrome in the appropriate clinical context.
- Prompt communication of these CT findings to the clinical team is essential for emergent surgical decompression and management of ACS.