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Canadian Journal of Anaesthesia

, Volume 44, Issue 3, pp 308–312 | Cite as

Abdominal compartment syndrome

  • Scott T. Reeves
  • Mark L. Pinosky
  • T. Karl Byrne
  • E. Douglas Norcross
Clinical reports

Abstract

Purpose

Two cases of abdominal compartment syndrome are described and the pathophysiology associated with it is reviewed.

Clinical Features

The first patient was a 46-yr-old man who sustained extensive blunt abdominal injuries following a fall. The second was a 54-yr-old man involved in a motor vehicle accident with blunt abdominal trauma. In both cases, the patients developed an extremely tense abdomen, increasing peak inspiratory pressures, hypercarbia and oliguna. Both demonstrated improvement in cardiac performance and ventilatory vanables following an emergency decompressive celiotomy.

Conclusion

Abdominal compartment syndrome results in impairment of organ function secondary to increased intraabdominal pressure. These patients require emergency decompressive celiotomy to relieve the symptoms. However, the incidence of intractable asystole and hypotension dunng this procedure is high and vigilance must be maintained dunng the release of the increased intraabdominal pressure.

Keywords

Inferior Vena Cava Compartment Syndrome Fresh Freeze Plasma Abdominal Compartment Syndrome Intraabdominal Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Rapporter deux cas de syndrome du compartiment abdominal et revoir sa physiopathologie.

Éléments cliniques

Le premier patient était un homme de 46 ans souffrant de contusions abdominales multiples graves consécutives à une chute. Le deuxième était un homme de 54 ans victime d’un accident de la route et affligé d’une contusion abdominale. Dans les deux cas, l’abdomen était devenu extrêmement tendu avec augmentation des pressions respiratoires maximales, de l’hypercarbie et de l’oligurie. Une coeliotomie décompressive en urgence a permis de normaliser la performance cardiaque et les paramètres ventilatoires.

Conclusion

Le syndrome du compartiment abdominal provoque un atteinte fonctionnelle organique secondaire à l’augmentation de la pression intra-abdominale. Son traitement nécessite une coeliotomie décompressive en urgence. Cependant, l’incidence d’asystolie et d’hypotension réfractaires pendant cette intervention demeure élevée. Il faut exercer une vigilance accrue au moment du relâchement de la pression intra-abdominale.

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Copyright information

© Canadian Anesthesiologists 1997

Authors and Affiliations

  • Scott T. Reeves
    • 1
  • Mark L. Pinosky
    • 1
  • T. Karl Byrne
    • 1
    • 2
  • E. Douglas Norcross
    • 1
  1. 1.Departments of Anesthesia & Perioperative MedicineMedical University of South CarolinaCharleston
  2. 2.Department of SurgeryMedical University of South CarolinaCharleston

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