European Journal of Trauma and Emergency Surgery

, Volume 34, Issue 4, pp 369–377

Postinjury Primary Abdominal Compartment Syndrome

  • Zsolt Balogh
  • Cino Bendinelli
  • Timothy Pollitt
  • Rosemary A. Kozar
  • Frederick A. Moore
Focus on Solid Organ Injury

DOI: 10.1007/s00068-008-8106-9

Cite this article as:
Balogh, Z., Bendinelli, C., Pollitt, T. et al. Eur J Trauma Emerg Surg (2008) 34: 369. doi:10.1007/s00068-008-8106-9

Abstract

Postinjury abdominal compartment syndrome (ACS) has evolved during the 1980s together with the introduction of damage control surgery (DCS) principles. DCS made it possible to salvage severely injured trauma patients who previously would have exsanguinated due to uncontrollable coagulopathic bleeding. These patients had severe hemorrhagic shock; their abdomens were tightly packed and had ongoing massive resuscitation. ACS is a lethal complication of the damage control patients. For today the pathophysiological characteristics of ACS are described, the intra-abdominal pressure is measured on many intensive care units. Postinjury ACS (primary and secondary) is one of the better characterized etiological types of ACS: risk factors, diagnostic criteria, independent predictors and preventive strategies are all well documented. Since the mortality of full-blown postinjury ACS is still unacceptably high and does not seem to improve with earlier decompression, prevention is the recommended strategy to decrease the morbidity and mortality. Open abdomen is one of the important preventive strategies but it is not free from morbidity and mortality. With aggressive open abdomen management in postinjury ACS these complications can be minimized. More importantly, timely hemorrhage control and hemostatic resuscitation are the likely solutions for more efficient prevention of the postinjury ACS.

Key Words

Abdominal compartment syndrome (ACS)Damage control surgery (DCS)Abdominal

Copyright information

© Springer 2008

Authors and Affiliations

  • Zsolt Balogh
    • 1
    • 4
  • Cino Bendinelli
    • 1
  • Timothy Pollitt
    • 1
  • Rosemary A. Kozar
    • 2
  • Frederick A. Moore
    • 3
  1. 1.Division of Surgery, Department of TraumatologyJohn Hunter Hospital and University of NewcastleNewcastleAustralia
  2. 2.Department of Surgery, Memorial Hermann HospitalUT-Houston Medical School, Texas Medical CenterHoustonUSA
  3. 3.Department of SurgeryMethodist Hospital, Texas Medical CenterHoustonUSA
  4. 4.Division of Surgery, Department of TraumatologyJohn Hunter Hospital and University of NewcastleNewcastleAustralia