What is Abdominal Compartment Syndrome?

Abdominal compartment syndrome refers to intra-abdominal condition that is responsible, both proximally and directly for compartment syndrome. The condition of compartment syndrome refers to when myofascial elements become subject to an increase in pressure, which leads to organ dysfunction and ischemia, or tissue death. In abdominal compartment syndrome, organ dysfunction may be related to intra-abdominal hypertension. In the 19th century, abdominal compartment syndrome was recognized when it was associated with respiratory function decline.

Typically, abdominal compartment syndrome is divided into three categories. Acute or primary abdominal compartment syndrome, happens when the intra-abdominal pathology is responsible for the compartment syndrome. In addition, abdominal compartment syndrome of the secondary type refers to when no discernible intra-abdominal injury is noticed, however injuries or trauma outside of the abdomen cause fluid to accumulate. The third classification refers to the chronic type of this condition. This usually occurs in conjunction with late-stage cirrhosis and ascites, or fluid in the abdomen.

Generally, the symptoms of abdominal compartment syndrome include an increase in the abdominal girth, increased respiration, and cyanosis, which refers to a bluish tint to the skin. In addition, the abdomen may be tender and tense. Sometimes, wheezing may be heard with a stethoscope examination of the lungs, because of pulmonary fluid presence. Frequently, because of organ failure, which may include kidney damage, a decrease in urinary output may be noted in patients with abdominal compartment syndrome.

Occasionally, patients who acquire this condition may be unable to communicate because they are often critically ill. In addition, individuals may be intubated, which makes talking difficult, or even impossible. In these patients, doctors must pay close attention because even subtle changes in this condition may cause further organ damage, or even prove to be life threatening. An increase in abdominal girth often suggests a increase in ascitic fluid, however this sign may be difficult to asses in obese patients, and therefore regularly monitoring girth is important.

Morbidity related to this condition stems from the effects of extensive multiple organ failure. Because of this, compartment syndrome of the abdominal type generally has a very high mortality rate. This mortality rate remains high, even in the presence of aggressive treatment. Many times, treating this condition does not result in a favorable outcome, however accepted treatments may include surgical intervention, the tapping of massive fluid, and the administration of diuretics, which help eliminate excess fluid in the body.