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[The abdominal compartment syndrome].

A L Rozeboom¹, B Havekes, P Steenvoorde

¹Afd. Heelkunde, Leids Universitair Medisch Centrum, Postbus 9600, 2300 RC Leiden.

Nederlands Tijdschrift Voor Geneeskunde

|July 13, 2005

Summary

Abdominal compartment syndrome (ACS) requires prompt recognition in at-risk patients presenting with increased intra-abdominal pressure and specific symptoms. Serial bladder pressure monitoring combined with clinical assessment is crucial for diagnosis and management.

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Area of Science:

Clinical Medicine
Surgical Critical Care

Background:

Abdominal compartment syndrome (ACS) is a life-threatening condition characterized by elevated intra-abdominal pressure.
Early diagnosis and management are critical for patient outcomes.

Observation:

Two cases illustrate ACS: a male patient with an abdominal aortic aneurysm and a female patient post-sigmoidectomy.
The male patient recovered after re-operation, while the female patient succumbed to intestinal perforation.
Vacuum-assisted wound closure was applied to the female patient's abdominal wound.

Findings:

ACS diagnosis involves recognizing increased intra-abdominal pressure with signs like oliguria, decreased cardiac output, and hypotension.
Bladder pressure measurement is the standard for assessing intra-abdominal pressure.

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A single bladder pressure measurement may not correlate with clinical status; serial measurements are preferred.

Implications:

Clinicians must maintain a high index of suspicion for ACS in susceptible patients.
Integrating serial bladder pressure trends with clinical evaluation improves diagnostic accuracy.
Effective management strategies for ACS are essential to improve survival rates in surgical patients.