User:Mr. Ibrahem/Abdominal compartment syndrome

Abdominal compartment syndrome (ACS) is when the abdomen develops high internal pressures, resulting in organ dysfunction. Symptoms may include a swollen and hard abdomen and decreased urine output. Among those who are intubated, ventilation becomes difficult. Complications may include kidney failure, respiratory failure, heart failure, ischemic bowel, and increased intracranial pressure; ending in multi organ system failure.

It may occur as a result of sepsis, pancreatitis, bleeding within the abdomen, enlarged or swollen intestines, burns, abdominal trauma or surgery, or large amounts of intravenous fluids. Factors that can worsen matters include obesity, pregnancy, high chest pressures, and placing a patient on their front. The underlying mechanism involves increased pressure, which affects the heart, lungs, kidneys, and brain. Diagnosis may be supported by measuring pressures above 20 mm Hg via a Foley catheter placed in the bladder.

Treatment involves keeping the blood pressure sufficiently high, while limiting intravenous fluids, together with efforts to decrease abdominal pressure. The goal blood pressure is at least 60 mm Hg above the intra-abdominal pressure. Abdominal pressure may be decreased by a gastric tube, neostigmine, laxatives or a rectal tube, and draining any ascitis. If this is not effective surgery to open the abdomen may be carried out.

Abdominal compartment syndrome occurs relatively commonly in the intensive care unit (ICU). The risk of death is as high as 70%. Increased abdominal pressure was first described in 1863 Etienne-Jules Marey, with its association with organ dysfunction noted in 1873. The current term came into use in 1989.