Abdominal compartment syndrome: Current concepts and management.

E E Montalvo-Jave, M Espejel-Deloiza, J Chernitzky-Camaño, C A Peña-Pérez, E Rivero-Sigarroa, L H Ortega-León

Journal: Revista de gastroenterologia de Mexico (English) 2021;85(4):443-451

PMID: 32847726

Abstract

Abdominal compartment syndrome occurs when 2 or more anatomic compartments have a sustained intra-abdominal pressure >20mmHg, associated with organ failure. Incidence is 2% and prevalence varies from 0% to 36.4%. A literature search was conducted utilizing different databases. Articles published from 1970 to 2018 were included, in English or Spanish, to provide the concepts, classifications, and comprehensive management in the approach to abdominal compartment syndrome, for its treatment and the prevention of severe complications associated with the entity. Intravesical pressure measurement is the standard diagnostic method. Treatment is based on evacuation of the intraluminal content, identification and treatment of intra-abdominal lesions, improvement of abdominal wall compliance, and optimum administration of fluids and tissue perfusion. Laparotomy is generally followed by temporary abdominal wall closure 5 to 7 days after surgery. Reconstruction is performed 6 to 12 months after the last operation. Abdominal compartment syndrome should be diagnosed and operated on before organic damage from the illness occurs. Kidney injury can frequently progress and is a parameter for considering abdominal decompression. Having a biomarker for early damage would be ideal. Surgical treatment is successful in the majority of cases. A multidisciplinary focus is necessary for the intensive care and reconstructive needs of the patient. Thus, efforts must be made to define and implement strategies for patient quality of life optimization.

Copyright © 2020 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

Address: Departamento de Cirugía, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Clínica de Cirugía Hepato-Pancreato-Biliar, Hospital General de México «Dr. Eduardo Liceaga», Ciudad de México, México; Clínica de Gastroenterología, Hospital Médica Sur, Ciudad de México, México. Electronic address: [email protected].; Clínica de Cirugía Hepato-Pancreato-Biliar, Hospital General de México «Dr. Eduardo Liceaga», Ciudad de México, México.; Departamento de Cirugía, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México.; Unidad de Terapia Intensiva, Hospital Médica Sur, Ciudad de México, México.; Departamento de Terapia Intensiva, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México.

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