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Abdominelles Kompartmentsyndrom

Abdominal compartment syndrome

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Zusammenfassung

Das abdominelle Kompartmentsyndrom (AKS) ist charakterisiert durch eine andauernde, pathologische Drucksteigerung in der Bauchhöhle von über 20 mmHg. Diese Drucksteigerung führt zu einer Sequenz von pathophysiologischen Veränderungen, in deren Folge nahezu alle Organsysteme in ihrer Funktion beeinträchtigt werden. Die häufigsten Ursachen des AKS sind Bauchtrauma, Ileus, abdominelle Infektionen und Sepsis, aber auch extraabdominelle Erkrankungen kommen als Auslöser in Frage. Goldstandard der Diagnosesicherung ist die wiederholte, indirekte Abschätzung des intraabdominellen Drucks über den Blasendruck. Die Inzidenz des AKS auf operativen Intensivstationen reicht bis 15%. Therapie der Wahl beim manifesten AKS ist die dekompressive Laparotomie. Die Letalität ist hoch und beträgt bis zu 60%.

Abstract

Abdominal compartment syndrome (ACS) is characterized by a persistent pathologic increase in intra-abdominal pressure (IAP) exceeding 20 mmHg with consecutive dysfunction of multiple organ systems. The main causes of ACS are abdominal trauma, obstruction, infection, and sepsis, but it may also be initiated by extra-abdominal diseases. The gold standard for diagnosis is repeated assessment of the IAP measurements of bladder pressure. The incidence of ACS is up to 15% in operative ICUs and the therapy of choice for it is decompressive laparotomy. Nevertheless, mortality is high, up to 60%.

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Authors and Affiliations

  1. Chirurgische Universitätsklinik und Poliklinik der RWTH Aachen, Pauwelsstraße 30, 52074 , Aachen

    P. Bertram, A. Schachtrupp, R. Rosch, O. Schumacher & V. Schumpelick

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  1. P. Bertram
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  2. A. Schachtrupp
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  3. R. Rosch
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  4. O. Schumacher
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  5. V. Schumpelick
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Correspondence to P. Bertram.

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Bertram, P., Schachtrupp, A., Rosch, R. et al. Abdominelles Kompartmentsyndrom. Chirurg 77, 573–579 (2006). https://doi.org/10.1007/s00104-006-1197-0

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