The abdominal compartment syndrome (ACS) in general surgery

The abdominal compartment syndrome is a life threatening clinical entity which can develop within the first 12 hours of intensive care unit admission in high-risk surgical patients. The aim of this paper is to show the definitions, ethiology, pathophysiology, diagnosis and treatment of this serious, not only surgical problem.

The mortality due to the abdominal compartment syndrome is extremely high (38-71%). It can be defined as adverse physiologic consequences that occur as a result of an acute increase in the intraabdominal pressure. The most common causes are retroperitoneal haemorrhage, visceral oedema, pancreatitis, bowel obstruction, tense ascites, peritonitis, tumor. The mostly affected systems are cardiovascular, pulmonary, renal, central nervous systems and splanchnic organs. The gold standard diagnostic method is the continuous intra-abdominal pressure monitoring. The treatment consists of adequate fluid resuscitation and surgical decompression.

We show three typical short case reports treated by the above mentioned theories.

Intraabdominal hypertension and abdominal compartment syndrome are frequent clinical findings among acute general surgical patients. Patients with comparable demographics and acute severity of illness are more likely to die if intraabdominal hypertension or abdominal compartment syndrome is present. We conclude that the early recognition and surgical decompression is urgent.