Review article: The abdominal compartment syndrome

Background: The term abdominal compartment syndrome refers to hypoperfusion and ischaemia of intra-abdominal viscera and structures caused by raised intra-abdominal pressure. It occurs most commonly following major trauma and complex surgical procedures, but can also occur in their absence. Definitive treatment is decompression at laparotomy. Prevention and recognition of abdominal compartment syndrome are crucial to avoid additional morbidity and mortality. Postinjury abdominal compartment syndrome continues to complicate current resuscitation methods and new strategies for resuscitating critically ill patients need to be explored in addition to more accurate monitoring of intra-abdominal pressure. Aim: To examine the published literature regarding the pathogenesis, diagnosis and management of the abdominal compartment syndrome. Methods: A comprehensive review of the literature was undertaken. Results: This syndrome is an important complication of major trauma and surgery as well as being recognized in critically-ill medical patients. It requires prompt recognition with a view to decompression at laparotomy. Conclusions: The abdominal compartment syndrome is an important complication of trauma, surgery and resuscitation. Key to its management are its prompt recognition and abdominal decompression.