Abdominal Compartment Syndrome
Raised intraabdominal pressure:
- Impairs venous outflow, resulting in:
- ↓ Systemic VR
- ↓ Renal and splanchnic blood flow
- Is classified into:
- Intraabdominal hypertension
IAP >12mmHg. - Abdominal compartment syndrome
IAP >20mmHg.
- Intraabdominal hypertension
Epidemiology and Risk Factors
Pathophysiology
↑ Volume of abdominal contents leads to an ↑ IAP, and is usually the result of gut oedema. Precipitants include:
- Trauma
- Laparotomy
- Capillary leak
- Sepsis
- Fluid administration
Clinical Manifestations
Diagnostic Approach and DDx
Investigations
Management
Resuscitation:
ABC approach. Comment on team coordination and clinical priorities. Specific therapy:
- Pharmacological
- Procedural
- Decompressive laparotomy with temporary fascial closure
- Physical
Supportive care:
Disposition: