Abdominal Compartment Syndrome

Abdominal compartment syndrome (ACS) is caused by increased pressure in the abdominal cavity (i.e., intraabdominal hypertension) and is most commonly seen in critically ill or injured patients. ACS can be caused by reduced abdominal wall compliance, visceral edema, increased luminal contents, or increased abdominal contents and manifests with organ dysfunction, including acute kidney failure, respiratory failure, and shock. Diagnosis is made with urinary bladder pressure measurement, which provides an indirect measure of intraabdominal pressure. Initial conservative measures are aimed at improving abdominal wall compliance, reducing abdominal cavity volume, and optimizing fluid balance and organ perfusion. If these measures fail to lower intraabdominal pressure, urgent decompressive laparotomy is required, typically followed by temporary abdominal closure.