Summary
Definition
History and exam
Key diagnostic factors
- abdominal distension
- oliguria
- increased respiratory effort
- hypotension
Risk factors
- excessive fluid resuscitation
- massive blood transfusion
- decreased abdominal compliance
- intra-abdominal infection/inflammation
- hemoperitoneum
- ileus
- pneumoperitoneum
- loss of abdominal domain
- comorbid cirrhosis
- retroperitoneal hematoma
Diagnostic tests
1st tests to order
- transbladder measurement of intra-abdominal pressure
- oxygen saturation
- BUN and creatinine
- ABG
Tests to consider
- peak airway pressure
- abdominal CT scan
- abdominal ultrasound
Emerging tests
- muscle contraction sensors
- continuous intragastric pressure monitoring
Treatment algorithm
all patients
Contributors
Authors
Patrick B. Murphy, MD, MPH, MSc, FRCSC, FACS
Associate Professor
Medical College of Wisconsin
Milwaukee, WI
Disclosures
PBM declares that the Medical College of Wisconsin receives honorariums for educational material provided to Boston Scientific.
Courtney Pokrzywa, MD
Surgical Critical Care/Acute Care Surgery Fellow
Medical College of Wisconsin
Milwaukee, WI
Disclosures
CP declares that she has no competing interests.
Acknowledgements
Dr Patrick B. Murphy and Dr Courtney Pokrzywa would like to gratefully acknowledge Dr Michael W. Cripps, Dr Jeffrey C. Perumean, Dr Michaela West, and Dr Gary An, previous contributors to this topic.
Disclosures
MWC has received compensation from Grifols for participation in their Advisory Board and has been compensated with stock options by TraumaCare.AI, Inc. for serving on their Advisory Board. JCP declares that he has no competing interests. MW and GA are authors of a reference cited in this topic.
Peer reviewers
Bart De Keulenaer, MD, FJFICM
Physician/Intensivist
Fremantle Hospital
Fremantle
Western Australia
Australia
Disclosures
BDK declares that he has no competing interests.
William Kirke Rogers, MD
Associate Professor of Anesthesiology and Critical Care Medicine
University of Minnesota
Minneapolis, MN
Disclosures
WKR declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
The World Society of the Abdominal Compartment Syndrome. WSACS consensus guidelines summary. Apr 2021 [internet publication].Full text
Montalvo-Jave EE, Espejel-Deloiza M, Chernitzky-Camaño J, et al. Abdominal compartment syndrome: current concepts and management. [in spa]. Rev Gastroenterol Mex (Engl Ed). 2020 Oct-Dec;85(4):443-51.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Shock
- Acute tubular necrosis
- Acute kidney injury
More DifferentialsGuidelines
- Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines
- Intra-abdominal hypertension and the open abdomen: nursing guidelines from the Abdominal Compartment Society
More Guidelines
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