Abdominal compartment syndrome

Last reviewed: 4 Jun 2022
Last updated: 14 Dec 2021

Summary

Definition

History and exam

Key diagnostic factors

  • abdominal distension
  • oliguria
  • increased respiratory effort
  • hypotension
More key diagnostic factors

Risk factors

  • excessive fluid resuscitation (>3 L in 24 hours)
  • massive blood transfusion (>10 units in 24 hours)
  • decreased abdominal compliance
  • intra-abdominal infection/inflammation
  • hemoperitoneum
  • ileus
  • pneumoperitoneum
  • loss of abdominal domain
  • comorbid cirrhosis
  • retroperitoneal hematoma
More risk factors

Diagnostic investigations

1st investigations to order

  • transbladder measurement of intra-abdominal pressure
  • oxygen saturation
  • BUN and creatinine
  • arterial blood gases
More 1st investigations to order

Investigations to consider

  • peak airway pressure
  • abdominal CT scan
  • abdominal ultrasound
More investigations to consider

Emerging tests

  • measurement of intra-abdominal pressure via vena cava, rectum, or abdominal cavity

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Michael W. Cripps, MD

Assistant Professor

Department of Surgery

Division of Burn/Trauma/Critical Care

University of Texas Southwestern Medical Center

Dallas

TX

Disclosures

MWC has been reimbursed by Hemosonics and Instrumentation Laboratory for consultancy.

Jeffrey C. Perumean, MD

Surgeon/Surgical Intensivist

Advanced Surgical Associates/Banner Health

Division of Trauma/Critical Care

Mesa

AZ

Disclosures

JCP declares that he has no competing interests.

Acknowledgements

Dr Michael Cripps and Dr Jeffrey Perumean would like to gratefully acknowledge Dr Michaela West and Dr Gary An, previous contributors to this topic. 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.

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  • Guidelines

    • Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines
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