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



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.


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.


Inferior Vena Cava Compartment Syndrome Fresh Freeze Plasma Abdominal Compartment Syndrome Intraabdominal Pressure 
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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.


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.


  1. 1.
    Schein M, Wittmann DH, Aprahamian CC, Condon RE. The abdominal compartment syndrome: the physiological and clinical consequences of elevated intra-abdominal pressure. J Am Coll Surg 1995; 180: 745–53.PubMedGoogle Scholar
  2. 2.
    Morris JA Jr, Eddy VA, Blinman TA, Rutherford EJ, Sharp KW. The staged celiotomy for trauma. Issues in unpacking and reconstruction. Ann Surg 1993; 217: 576–86.PubMedCrossRefGoogle Scholar
  3. 3.
    McCabe JB, Seidel DR, Jagger JA. Antishock trouser inflation and pulmonary vital capacity. Ann Emerg Med 1983; 12: 290–3.PubMedCrossRefGoogle Scholar
  4. 4.
    Lameier D, NeCamp D. Measuring intraabdominal pressure. Crit Care Nurse 1990; 10: 54–66.PubMedGoogle Scholar
  5. 5.
    Bendahan J, Coetzee CJ, Papagianopoulos C, Muller R. Abdominal compartment syndrome. Journal of Trauma: Injury, Infection and Critical Care 1995; 38: 152–3.CrossRefGoogle Scholar
  6. 6.
    Cullen DJ Coyle JP, Teplick R, Long MC. Cardiovascular, pulmonary, and renal effects of massively increased intra-abdominal pressure in critically ill patients. Crit Care Med 1989; 17: 118–21.PubMedCrossRefGoogle Scholar
  7. 7.
    Obeid F, Saba A, Fath J, et al. Increases in intraabdominal pressure affect pulmonary compliance. Arch Surg 1995; 130: 544–8.PubMedGoogle Scholar
  8. 8.
    Shelly MP, Robinson AA, Herford JW, Park GR. Haemodynamic effects following surgical release of increased intra-abdominal pressure. Br J Anaesth 1987; 59: 800–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Eddy VA, Key SP, Morris JA Jr. Abdominal compartment syndrome: etiology, detection, and management. J Tenn Med Assoc 1994; 87: 55–7.PubMedGoogle Scholar
  10. 10.
    Harman PK, Kron IL, McLachlan HD, Freedlender AE, Nolan SP. Elevated intra-abdominal pressure and renal function. Ann Surg 1982; 196: 594–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Meldrum DR, Moore FA, Moore EE, Haenel JB, Cosgriff N, Burch JM. Cardiopulmonary hazards of perihepatic packing for major liver injuries. Am J Surg 1995; 170: 537–42.PubMedCrossRefGoogle Scholar
  12. 12.
    Hirshberg A, Wall MJ, Mattox KL. Planned reoperation for trauma: a two year experience with 124 consecutive patients. J Trauma 1994; 37: 365–9.PubMedCrossRefGoogle Scholar

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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