Abdominal Compartment Syndrome: Case Report

Abdominal compartment syndrome (ACS) was originally described in trauma patients but is now known to occur in critically ill patients with a myriad of acute illnesses. Recent epidemiological studies have characterized the prevalence of intraabdominal hypertension (defi ned as an intraabdominal pressure [IAP] measured at the urinary bladder ¡Ý12 mmHg) between 2% and 33% [1,2] and the prevalence of ACS (defi ned as an IAP ¡Ý20 mmHg and associated organ system dysfunction) between 1% and 15%. These prevalences are similar to those quoted for sepsis and septic shock in trauma patients. Multiple studies have shown that massive fl uid resuscitation is the most common risk factor for ACS. The rise in intraabdominal pressure causes worsening of the capillary leak as a consequence of their primary illness, further decreasing vital organ perfusion and resulting in multiple organ dysfunction syndrome (MODS). Management includes hemodynamic support and abdominal decompression. Because of its protean manifestations, a high index of suspicion and frequent monitoring of the IAP in high-risk patients are the best preventive measures. Our case report shows the clinical features of a patient with ACS. The diagnosis was made early in the clinical source, yet appropriate management was deferred because of the uncertainty management in this critically ill patient.