Advertisement

Surgery Today

, Volume 38, Issue 1, pp 5–19 | Cite as

Abdominal Compartment Syndrome

  • Georgi Petrov Deenichin
Review Articles

Abstract

Compartment syndrome is a pathophysiological term, comprising a variety of tissues and organ alterations, due to a higher than normal pressure in an anatomically detached space (compartment). In the human body, areas denoted as compartments include the orbital globe, the sub and epidural space, the abdomen, pleura, pericardium, and others. Compartment syndrome was described initially in limbs. Abdominal compartment syndrome is defined as an intra-abdominal pressure above 20 mmHg with evidence of organ failure. Abdominal compartment syndrome develops when the intra-abdominal pressure rapidly reaches certain pathological values, within several hours (intra-abdominal hypertension is observed), and lasts for 6 or more hours. The key to recognizing abdominal compartment syndrome is the demonstration of elevated intra-abdominal pressure which is performed most often via the urinary bladder, and it is considered to be the “gold standard.” Multiorgan failure includes damage to the cardiac, pulmonary, renal, neurological, gastrointestinal, abdominal wall, and ophthalmic systems. The gut is the most sensitive to intra-abdominal hypertension, and it develops evidence of end-organ damage before alterations are observed in other systems. The surgical decompression of the abdomen remains the treatment of choice of abdominal compartment syndrome; this usually improves the organ changes, and is followed by one of the temporary abdominal closure techniques in order to prevent secondary intra-abdominal hypertension.

Key words

Abdominal compartment syndrome Intra-abdominal hypertension Intravesical pressure Temporary abdominal closure 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Malbrain, ML, Cheatman, ML, Kirkpatrick, A, Surgue, M, Parr, M, De Waele, J,  et al. 2006Results from the International Conference of Experts on Intra-Abdominal Hypertension and Abdominal Compartment SyndromeIntensive Care Med32172232PubMedCrossRefGoogle Scholar
  2. 2.
    Saggi, BH, Sugerman, HJ, Ivatury, RR, Bloomfield, GL 1998Abdominal compartment syndromeJ Trauma45597609PubMedGoogle Scholar
  3. 3.
    Diebel, LN, Dulchavsky, SA, Wilson, RF 1992Effects of increased intra-abdominal pressure on mesenteric arterial and intestinal mucosal blood flowJ Trauma33459PubMedGoogle Scholar
  4. 4.
    Diebel, LN, Myers, T, Dulchavsky, SA 1997Effects of increased airway pressure and PEEP on the assessment of cardiac preloadJ Trauma4258590PubMedGoogle Scholar
  5. 5.
    Ivatury, RR, Diebel, LN, Porter, JM, Simon, RJ 1997Intra-abdominal hypertension and the abdominal compartment syndromeSurg Clin North Am77783800PubMedCrossRefGoogle Scholar
  6. 6.
    Burch, JM, Moore, EE, Moore, FA, Franciose, R 1996The abdominal compartment syndromeSurg Clin North Am7683342PubMedCrossRefGoogle Scholar
  7. 7.
    Kron, IL, Harman, PK, Nolan, SP 1984The measurement of intra-abdominal pressure as a criterion for abdominal re-explorationAnn Surg1992830PubMedCrossRefGoogle Scholar
  8. 8.
    Surgue, M, Jones, F, Lee, A, Buist, MD, Deane, SA, Bauman, A,  et al. 1996Intra-abdominal pressure and gastric intramucosal pH: is there an association?World J Surg2098891CrossRefGoogle Scholar
  9. 9.
    Ivatury, RR, Simon, RJ, Islam, S, John, R, Stahl, WM 1997Intraabdominal hypertension, gastric mucosal pH and the abdominal compartment syndromeJ Trauma43194Google Scholar
  10. 10.
    Mohaparta, B 2004Abdominal compartment syndromeIndian J Crit Care Med82632Google Scholar
  11. 11.
    Malbrain, MLNG, Debareye, Y, Bertieaux, S 2000Effects of abdominal compression and decompression on cardiorespiratory function and regional perfusionIntensive Care Med26264Google Scholar
  12. 12.
    Moore, AF, Hargest, R, Delicata, RJ 2004Intra-abdominal hypertension and the abdominal compartment syndromeBr J Surg91110210PubMedCrossRefGoogle Scholar
  13. 13.
    Tons, Ch, Schachtrupp, A, Rau, M, Schumpelick, V, Mumme, Th 2000Abdominal compartment syndrome: prevention and treatmentChirurg7191826PubMedCrossRefGoogle Scholar
  14. 14.
    Malbrain, MLNG, Chiumello, D, Pelosi, P, Wilmer, A, Brienza, N, Malcangi, V,  et al. 2004Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological studyIntensive Care Med308229PubMedCrossRefGoogle Scholar
  15. 15.
    Schein, M, Wittmann, DH, Aprahamian, CC, Condon, RE 1995The abdominal compartment syndrome: the physiological and clinical consequences of elevated intra-abdominal pressureJ Am Coll Surg18074553PubMedGoogle Scholar
  16. 16.
    Surgue, M 2005Abdominal compartment syndromeCurr Opin Crit Care113338CrossRefGoogle Scholar
  17. 17.
    De Potter, TGR, Dits, H, Malbrain, MNLG 2005Intra and interobserver variability during in vitro validation of two novel methods for intra-abdominal pressure monitoringIntensive Care Med3174751PubMedCrossRefGoogle Scholar
  18. 18.
    Yukioka, T, Muraoka, A, Kanai, N 2002Abdominal compartment syndrome following damage-pathophysiology and decompression of intraabdominal pressureNippon Geka Gakkai Zasshi10352935PubMedGoogle Scholar
  19. 19.
    Schachtrupp, A, Henzler, D, Orfao, S, Schaefer, W, Schwab, R, Becker, P,  et al. 2006Evaluation of a modified pieziresistive technique and a water-capsule technique for direct and continuous measurement of intra-abdominal pressure in a porcine modelCrit Care Med349168CrossRefGoogle Scholar
  20. 20.
    Wittmann, DH, Iskander, GA 2000The compartment syndrome of the abdominal cavity: a state of the art reviewJ Intensive Care Med1520120CrossRefGoogle Scholar
  21. 21.
    Malbrain, MLNG, Deeren, DH 2006Effect of bladder volume on measured intravesical pressure: a prospective cohort studyCrit Care1098CrossRefGoogle Scholar
  22. 22.
    Reis, R, Labas, P, Vician, M, Ziak, M 2003The abdominal compartment syndromeBratisl Lek Listy104325PubMedGoogle Scholar
  23. 23.
    Rozov, R, Pottecher, T, Launoy, A 2004Intra-abdominal pressure measurement using a bladder catheterAnn Fr Anesth Reanim234334PubMedCrossRefGoogle Scholar
  24. 24.
    McNelis, J, Soffer, S, Marini, CP, Jurkiewicz, A, Ritter, G, Simms, HH,  et al. 2002Abdominal compartment syndrome in the surgical intensive care unitAm Surg681823PubMedGoogle Scholar
  25. 25.
    Deeren, DH, Dits, H, Malbrain, MLNG 2005Correlation between intra-abdominal and intracranial pressure in nontraumatic brain injuryIntensive Care Med31157781PubMedCrossRefGoogle Scholar
  26. 26.
    Malbrain, MLNG 2004Is it wise not to think about intraabdominal hypertension in the ICU?Curr Opin Care1013245CrossRefGoogle Scholar
  27. 27.
    Balogh, Z, Jones, F, D'Amours, S, Parr, M, Surgue, M 2004Continuous intra-abdominal pressure measurement techniqueAm J Surg18867984PubMedCrossRefGoogle Scholar
  28. 28.
    Malbrain, MLNG 2004Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisalIntensive Care Med3035771PubMedCrossRefGoogle Scholar
  29. 29.
    Pickhardt, PJ, Shimony, JS, Heiken, JP, Buchman, TG, Fisher, AJ 1999The abdominal compartment syndrome: CT findingsAm J Roentgenol1735759Google Scholar
  30. 30.
    Surgue, M 1995Intra-abdominal pressureClin Intensive Care6769CrossRefGoogle Scholar
  31. 31.
    Surgue, M, Hilman, KM 1998Intraabdominal hypertension and intensive careVinsent, JL eds. Yearbook of intensive care and emergency medicineSpringerBerlin Heidelberg New York66776Google Scholar
  32. 32.
    Malbrain, MLNG 2000Abdominal pressure in the critically illCurr Opin Crit Care61729CrossRefGoogle Scholar
  33. 33.
    Surgue, M, Jones, F, Deane, SA, Bishop, G, Bauman, A, Hillman, K 1999Intra-abdominal hypertension is an independent cause of postoperative renal impairmentArch Surg13410825CrossRefGoogle Scholar
  34. 34.
    Jacques, T, Le, R 1988Improvement of renal function after relief of raised intra-abdominal pressure due to traumatic retroperitoneal haematomaAnaesth Intens Care1647882Google Scholar
  35. 35.
    Lindstrom, P, Wadstrom, J, Ollestram, A, Johnson, C, Persson, AE 2003Effects of increased intra-abdominal pressure and volume expansion on renal function in the ratNephrol Dial Transplant18226977PubMedCrossRefGoogle Scholar
  36. 36.
    Hunter, JD, Damani, Z 2004Intra-abdominal hypertension and the abdominal compartment syndromeAnaesthesia59899907PubMedCrossRefGoogle Scholar
  37. 37.
    Malbrain MLNG. Intra-abdominal pressure in the intensive care unit: clinical tool or a toy? In: Yearbook of intensive care and emergency medicine. Berlin Heidelberg New York: Springer; 2001. p. 547–85Google Scholar
  38. 38.
    Diebel, L, Saxe, J, Dulchavsky, S 1992Effect of intra-abdominal pressure on abdominal wall blood flowAm Surg585736PubMedGoogle Scholar
  39. 39.
    Nathens, AB, Brenneman, FD, Boulanger, BR 1997The abdominal compartment syndromeCan J Surg4254Google Scholar
  40. 40.
    Fischbach, M, Terzic, J, Provot, E, Weiss, L, Bergere, V, Menouer, S,  et al. 2003Intraperitoneal pressure in children: fill-volume related and impacted by body mass indexPerit Dial Int233914PubMedGoogle Scholar
  41. 41.
    Joseph, DK, Dutton, RP, Aarabi, B, Scalea, TM 2004Decompressive laparotomy to treat intracranial hypertension after traumatic brain injuryJ Trauma5768793PubMedGoogle Scholar
  42. 42.
    Andrews, PJ, Citerio, G 2004Intracranial pressure. I. Historical overview and basic conceptsIntensive Care Med3017303PubMedCrossRefGoogle Scholar
  43. 43.
    De Waele, JJ, Benoit, D, Hoste, E, Colardyn, F 2003A role for muscle relaxation in patients with abdominal compartment syndrome?Intensive Care Med29332PubMedGoogle Scholar
  44. 44.
    Malbrain MLNG. Abdominal perfusion pressure as a prognostic marker in intra-abdominal hypertension. In: Yearbook of intensive care and emergency medicine. Berlin Heidelberg New York: Springer; 2001. p. 547–85Google Scholar
  45. 45.
    Gennerelli, TA, Champion, HR, Copes, WS, Sacco, WJ 1994Comparison of mortality, morbidity, and severity in 59 713 head injured patients with 114 447 patients with extracranial injuriesJ Trauma379628CrossRefGoogle Scholar
  46. 46.
    Priluck, IA, Blodgett, DW 1996The effects of increased intra-abdominal pressure on the eyesNebr Med J8189PubMedGoogle Scholar
  47. 47.
    Balogh, Z, McKinley, BA, Holcomb, JB, Miller, CC, Cocanour, CS, Kozar, RA,  et al. 2003Both primary and secondary abdominal compartment syndrome can be predicted early and are harbingers of multiple organ failureJ Trauma5484859PubMedCrossRefGoogle Scholar
  48. 48.
    Balogh, Z, Moore, FA 2003Post-injury abdominal compartment syndrome: summary of the recent advancementsTrauma Grapevine34956Google Scholar
  49. 49.
    Balogh, Z, McKinley, BA, Cocanour, CS, Kozar, RA, Holcomb, JB, Ware, DN,  et al. 2002Secondary abdominal compartment syndrome is an elusive early complication of traumatic shock resuscitationAm J Surg18453843PubMedCrossRefGoogle Scholar
  50. 50.
    Oda, J, Yamashita, K, Inoue, T, Harunari, N, Ode, Y, Mega, K,  et al. 2006Resuscitation fluid volume and abdominal compartment syndrome in patients with major burnsBurns321514PubMedCrossRefGoogle Scholar
  51. 51.
    Sieh, KM, Chu, KM, Wong, J 2001Intra-abdominal hypertension and abdominal compartment syndromeLangenbecks Arch Surg3865361PubMedCrossRefGoogle Scholar
  52. 52.
    Shiiya, N, Matsuzaki, K, Miyatake, T, Yoshimoto, K, Yasuda, K 2005Abdominal compartment syndrome causing respiratory failure during surgery for ruptured descending thoracic aneurism: report of a caseSurg Today353202PubMedCrossRefGoogle Scholar
  53. 53.
    Balogh, Z, McKinley, BA, Cocanour, CS, Kozar, RA, Valdivia, A, Sailors, RM 2003Supranormal trauma resuscitation causes more cases of abdominal compartment syndromeArch Surg13863742PubMedCrossRefGoogle Scholar
  54. 54.
    Mayberry, JC, Goldman, RK, Millins, RJ, Brand, DM, Crass, RA, Trunkey, DD 1999Surveyed opinion of American trauma surgeons on prevention of the abdominal compartment syndromeJ Trauma4750913PubMedGoogle Scholar
  55. 55.
    Schein, M, Ivatury, R 1998Intra-abdominal hypertension and the abdominal compartment syndromeBr J Surg85192728Google Scholar
  56. 56.
    Montalvo, JA, Acosta, JA, Rodriguez, P, Alejandro, K, Sarraga, A 2005Surgical complications and causes of death in trauma patients that require temporary abdominal closureAm Surg7121924PubMedGoogle Scholar
  57. 57.
    Schachtrupp, A, Hoer, J, Tons, C, Klinge, U, Reckord, U, Schumpelick, V 2002Intra-abdominal pressure: a reliable criterion for laparostomy closure?Hernia61027PubMedCrossRefGoogle Scholar
  58. 58.
    Cheatham, ML, Safecsak, K, Llerena, LE, Morrow, CE,Jr, Block, EF 2004Long-term physical, mental, and functional consequences of abdominal decompressionJ Trauma5623741PubMedGoogle Scholar
  59. 59.
    Saleem, TB, Ahmed, I 2004Recent advances in the management of abdominal compartment syndromeJ Coll Phys Surg Pak143815Google Scholar
  60. 60.
    Surgue, M 2002Intra-abdominal pressure: time for clinical practice guidelines?Intensive Care Med2838991CrossRefGoogle Scholar
  61. 61.
    Meldrum, DR, Moore, FA, Moore, EE, Fransoise, R, Sauaia, A, Burch, JM 1997Prospective characterization and selective management of the abdominal compartment syndromeAm J Surg17466772PubMedCrossRefGoogle Scholar
  62. 62.
    Bailey, J, Shapiro, MJ 2000Abdominal compartment syndromeCrit Care4239PubMedCrossRefGoogle Scholar
  63. 63.
    Swan, MC, Banwell, PE 2005The open abdomen: aetiology, classification and current management strategiesJ Wound Care14711PubMedGoogle Scholar
  64. 64.
    De Waele, JJ, Hoste, EA, Malbrain, MLNG 2006Decompressive laparotomy for abdominal compartment syndrome-a critical analysisCrit Care1051CrossRefGoogle Scholar
  65. 65.
    Schachtrupp, A, Jansen, M, Bertram, P, Kuhlen, R, Schumpelick, V 2006Abdominal compartment syndrome: significance, diagnosis and treatmentAnaesthesist556607PubMedCrossRefGoogle Scholar
  66. 66.
    Ivatury, RR 2006Abdominal compartment syndrome: a century later, isn't it time to accept and promulgate?Crit Care Med3424945PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 2008

Authors and Affiliations

  • Georgi Petrov Deenichin
    • 1
  1. 1.Department of Surgery IIIMedical University Faculty of MedicinePlovdivBulgaria

Personalised recommendations