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Canadian Journal of Anesthesia, Vol 44, 308-312, Copyright © 1997 by Canadian Anesthesiologists' Society

ARTICLES

Abdominal compartment syndrome

ST Reeves, ML Pinosky, TK Byrne and ED Norcross
Department of Anesthesia, Medical University of South Carolina, Charleston 29425-2207, USA. Reevess@MUSC.edu

PURPOSE: Two cases of abdominal compartment syndrome are described and the pathophysiology associated with it is reviewed. CLINICAL FEATURES: The first patient was a 46-yr-old man who sustained extensive blunt abdominal injuries following a fall. The second was a 54-yr-old man involved in a motor vehicle accident with blunt abdominal trauma. In both cases, the patients developed an extremely tense abdomen, increasing peak inspiratory pressures, hypercarbia and oliguria. Both demonstrated improvement in cardiac performance and ventilatory variables following an emergency decompressive celiotomy. CONCLUSION: Abdominal compartment syndrome results in impairment of organ function secondary to increased intraabdominal pressure. These patients require emergency decompressive celiotomy to relieve the symptoms. However, the incidence of intractable asystole and hypotension during this procedure is high and vigilance must be maintained during the release of the increased intraabdominal pressure.


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Copyright © 1997 by the Canadian Anesthesiologists' Society.