Abdominal Compartment Syndrome in Surgical Patients

Abstract

Background: The deleterious effects of intraabdominal hypertension and abdominal compartment syndrome, affect almost every system. Patients at risk are the critically ill, in whom it leads to altered organ perfusion and end organ dysfunction/failure. The five cases reported highlight the diagnostic and management challenges. Case Presentation: Five patients with variable degrees of multiple organ dysfunction/failure as evidenced by derangements in laboratory and clinical parameters are presented. Non-surgical interventions including insertion or repositioning of nasogastric tube, insertion of flatus tube, careful titration of IV fluid requirements and appropriate adjustments of ventilator setting were instituted. All five did not respond to initial management and decompressive laparotomy or re-opening of the abdomen was planned. Conclusion: Abdominal compartment syndrome can be prevented by regular measurement of intraabdominal pressure in patients at risk. Non-surgical means should precede decompressive laparotomy but timely surgical intervention is crucial.