Abdominal compartment syndrome an under-recognized salient killer

ABSTRACT

Abdominal compartment syndrome is an underdiagnosed surgical entity that carries serious consequences. High index of suspicion and identifying patients at risk cannot be overemphasized. to raise awareness of this syndrome with reference to diagnosis and management. Patients and 12 patients with clinical diagnosis of abdominal compartment syndrome, confirmed by measurement of intracystic pressure in 8 patients. Abdominal decompression was performed in 9 patients. Clinical parameters were recorded before and after decompression. 48.4% reduction in peak inspiratory pressure, 19.3% increase in arterial oxygen tension, 81.4% increase in urine output, 8.3% increase in Glasgow coma score of head injury, 12.7% increase in systolic blood pressure and 66.1% drop in central venous pressure. There was a 43.8% drop in the intraabdominal pressure. Abdominal compartment syndrome is potentially fatal, if diagnosis and intervention are not timely performed. Measurement of the intra-vesical pressure provides an objective clue to monitor this condition, but should not rule out the clinical diagnosis. Abdominal decompression is a proven lifesaving intervention. Closing the abdomen under severe tension in high risk patients should be abandoned. Sudden release of high intra-abdominal pressure can lead to sudden death and should be watched for. Wound complications after decompression procedure are not uncommon but saving patient's life is the priority