Leon M, Chavez L, Surani S. Abdominal compartment syndrome among surgical patients. World J Gastrointest Surg 2021; 13(4): 330-339 [PMID: 33968300 DOI: 10.4240/wjgs.v13.i4.330]
Corresponding Author of This Article
Salim Surani, FACC, FACP, FCCP, MD, Professor, Department of Medicine, Texas A&M University, 701 Ayers Street, Corpus Christi, TX 78405, United States. srsurani@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Apr 27, 2021; 13(4): 330-339 Published online Apr 27, 2021. doi: 10.4240/wjgs.v13.i4.330
Abdominal compartment syndrome among surgical patients
Monica Leon, Luis Chavez, Salim Surani
Monica Leon, Department of Medicine, Centro Medico ABC, Ciudad de Mexico 01120, Mexico
Luis Chavez, Department of Medicine, University of Texas, El Paso, TX 79905, United States
Salim Surani, Department of Medicine, Texas A&M University, Corpus Christi, TX 78405, United States
Author contributions: Leon M and Chavez L have been involved in literature search, writing, and revision; Surani S has been involved in idea, writing and revision of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict-of-interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, FACC, FACP, FCCP, MD, Professor, Department of Medicine, Texas A&M University, 701 Ayers Street, Corpus Christi, TX 78405, United States. srsurani@hotmail.com
Received: January 12, 2021 Peer-review started: January 12, 2021 First decision: February 14, 2021 Revised: February 25, 2021 Accepted: March 22, 2021 Article in press: March 22, 2021 Published online: April 27, 2021
Abstract
Abdominal compartment syndrome (ACS) develops when organ failure arises secondary to an increase in intraabdominal pressure. The abdominal pressure is determined by multiple factors such as blood pressure, abdominal compliance, and other factors that exert a constant pressure within the abdominal cavity. Several conditions in the critically ill may increase abdominal pressure compromising organ perfusion that may lead to renal and respiratory dysfunction. Among surgical and trauma patients, aggressive fluid resuscitation is the most commonly reported risk factor to develop ACS. Other conditions that have also been identified as risk factors are ascites, hemoperitoneum, bowel distention, and large tumors. All patients with abdominal trauma possess a higher risk of developing intra-abdominal hypertension (IAH). Certain surgical interventions are reported to have a higher risk to develop IAH such as damage control surgery, abdominal aortic aneurysm repair, and liver transplantation among others. Close monitoring of organ function and intra-abdominal pressure (IAP) allows clinicians to diagnose ACS rapidly and intervene with target-specific management to reduce IAP. Surgical decompression followed by temporary abdominal closure should be considered in all patients with signs of organ dysfunction. There is still a great need for more studies to determine the adequate timing for interventions to improve patient outcomes.
Core Tip: Abdominal compartment syndrome (ACS) is a complication of several surgical and medical conditions that increase the intra-abdominal pressure (IAP) and cause organ hypoperfusion. Diagnosis is made by adequately measuring IAP and identifying the presence of intra-abdominal hypertension (IAH) with secondary organ dysfunction. IAH may progress to ACS when blood flow to multiple organs is compromised. Medical management aiming to decrease IAP should be started promptly to improve outcomes. Signs of organ hypoperfusion or evident organ failure warrants a rapid surgical evaluation for abdominal decompression. Close monitoring and rapid interventions are the key to improve the outcome in this complex condition.
