ABDOMINAL COMPARTMENT SYNDROME
SATURDAY, JULY 24, 2010
Compartment syndrome occurs when a fixed compartment, defined by myofascial elements or bone, becomes subject to increased pressure, leading to ischemia and organ dysfunction.Organ dysfunction caused by intra-abdominal hypertension (IAH) is considered to be abdominal compartment syndrome.The dysfunction may be respiratory insufficiency secondary to compromised tidal volumes, decreased urine output caused by falling renal perfusion, or any organ dysfunction caused by increased abdominal compartment pressure.
Abdominal compartment syndrome can be divided into the following 3 categories
* Primary or acute abdominal compartment syndrome: This occurs when intra-abdominal pathology is directly and proximally responsible for the compartment syndrome.(Penetrating trauma,Intraperitoneal hemorrhage,Pancreatitis,Rupture of abdominal aortic aneurysm and Perforated peptic ulcer)
* Secondary abdominal compartment syndrome: This occurs when no visible intra-abdominal injury is present but injuries outside the abdomen cause fluid accumulation.
* Chronic abdominal compartment syndrome: This occurs in the presence of cirrhosis and ascites, often in the later stages of the disease.
The morbidity of abdominal compartment syndrome is attributed to metabolic acidosis, decreased urine output, and decreased cardiac output.
Abdominal pain may precede the development of abdominal compartment syndrome and be directly related to a precipitating event, such as blunt abdominal trauma or pancreatitis.Abdominal pain and distension and signns of hypovolaemia are commonly present.
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