Transcript Abdominal compartment syndrome

ABDOMINAL COMPARTMENT
SYNDROME
IRIS MIYASAKI
APRIL 25, 2014.
ABDOMINAL COMPARTMENT
SYNDROME (ACS)
• Increased pressure in abdomen
 Ischemia
 Organ dysfunction
• Growing frequency in ED and ICU
 Morbidity
 Metabolic acidosis
 Decreased urine output
 Decreased cardiac output
ETIOLOGY
• Acute
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Trauma
Intraperitoneal hemorrhage
Pancreatitis
Pelvic fx
Perforated peptic ulcer
Rupture abdominal aortic
aneurysm
ETIOLOGY
• Secondary
• Penetrating or blunt trauma
without identifiable injury
• Postoperative
• Packing and primary fascial
closure, which increases
incidence Sepsis
• Large-volume resuscitation
• Large areas of full-thickness
burn
ETIOLOGY
• Chronic
• Peritoneal dialysis
• Morbid obesity
• Cirrhosis
• Meigs syndrome
SYMPTOMS
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Increase in abdominal girth
Decreased urine output
Syncope
Melena
Alcohol abuse
History of pancreatitis
COMPLICATIONS
• Intubated patients difficult to ventilate
• Patients who have GI bleeding or pancreatitis
Severe burns or sepsis with decreasing urine output
and are not responding to IV fluids and pressors
• Contradictory Swann-Ganz readings
TREATMENT
• Non-operative
• Reduction of intraabdominal volume
• Evacuation of intraabdominal of space-occupying lesions
• Improve abdominal wall compliance
• Operative
• Surgical decompression
RESOURCES
• http://emedicine.medscape.com/article/829008overview
• http://www.uptodate.com/contents/abdominalcompartment-syndrome
• http://journals.lww.com/jtrauma/Abstract/2003/100
00/Letters_to_the_Editor.11.aspx