IntraAbdominal Hypertension and Abdominal Compartment Syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Xinping

Department of Surgery, Huangpu Center Hospital, Shanghai 200002;

Corresponding author：

Keywords：

Intra-abdominal hypertension Abdominal compartment syndrome Pathophysiology

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ObjectiveTo study the concepts and pathophysiology of intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS). MethodsRelevant information was gathered from previous original articals,and by checking the latest issues of appropriate journals. Meantime computerised MEDLINE search from 1998 to August 2001 was conducted using the Medical Subject Heading and textwords “abdominal”, “compartment syndromes”, “intraabdominal” and “hypertention” and “pressure”.Then the literature in the recent two years about the advances of IAH and ACS were reviewed. Especially the concepts, pathophysiology and clinical application of IAH and ACS were mainly summarized.ResultsAkin to compartment syndrome, the pathophysiological effects of increased intraabdominal pressure developed well before any clinical evidence of compartment syndrome. These changes included ①reduction of gastrointestinal blood flow，②increase of respiratory airway pressure whereas decrease of pulmonary compliance，③decline in cardiac output but rise in peripheral vascular pressure，④oliguria even anuria，⑤increase of intracranial pressure，⑥decrease of hepatic blood flow，⑦decrease of abdominal wall compliance.ACS can be defined as dysfunction of various organs caused by a progressive unphysiologic increase of the intraabdominal pressure. Clinically the syndrome is characterised by inadequate ventilation, tensely distended abdomen and oliguria or anuria.Early decompression by simple laparotomy and delayed closure is the treatment of choice. ConclusionThe concepts of IAH and ACS have been increasingly accepted. They mainly affects the respiratory,cardiovascular and renal systems; secondarily affect gastrointestinal, central nervous systems,liver and abdominal wall. The reduction of cardiac output and pulmonary compliance are probably promoting factors inducing organ dysfunction.

Citation： YANG Xinping,JIANG Hongchi.. IntraAbdominal Hypertension and Abdominal Compartment Syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(6): 451-453. doi: Copy

1.	Grubben AC, van Baardwijk AA，Broering DC，et al. Pathophysiology and clinical significance of the abdominal compartment syndrome[Ｊ]. Zentralbl Chir,2001； 126（8）∶605.
2.	Tons C,Schachtrupp A,Rau M,et al.Abdominal compartment syndrome: prevention and treatment[Ｊ]. Chirurg,2000； 71（8）∶918.
3.	Sanchez NC, Tenofsky PL, Dort JM, et al. What is normal intraabdominal pressure? [Ｊ]. Am Surg,2001； 67（3）∶243.
4.	Kirkpatrick AW, Brenneman FD, Mclean RF, et al. Is clinical examination an accurate indicator of raised intraabdominal pressure? [Ｊ]. Can J Surg,2000； 43（3）∶207.
5.	Varela JE, Cohn SM, Giannotti GD, et al. Nearinfrared spectroscopy reflects changes in mesenteric and systemic perfusion during abdominal compartment syndrome[Ｊ]. Surgery, 2001； 129（3）∶363.
6.	Joynt GM, Ramsay SJ, Buckley TA. Intraabdominal hypertensionmplications for the intensive care physician[Ｊ]. Ann Acad Med Singapore,2001； 30（3）∶310.
7.	Offner PJ, de Souza AL, Moore EE, et al. Avoidance of abdominal compartment syndrome in damagecontrol laparotomy after trauma[Ｊ]. Arch Surg,2001； 136（6）∶676.
8.	Ertel W, Oberholzer A, Platz A, et al. Incidence and clinical pattern of the abdominal compartment syndrome after “damagecontrol” laparotomy in 311 patients with severe abdominal and/or pelvic trauma[Ｊ]. Crit Care Med, 2000； 28（6）∶1747.
9.	Sieh KM, Chu KM, Wong J. Intraabdominal hypertension and abdominal compartment syndrome[Ｊ]. Langenbecks Arch Surg,2001； 386（1）∶53.
10.	Berger P, Nijsten MW, Paling JC, et al. The abdominal compartment syndrome: a complication with many faces[Ｊ]. Neth J Med,2001； 58（5）∶197.
11.	Blevins DV, Khanduja KS. Abdominal compartment syndrome with massive lowerextremity edema caused by colonic obstruction and distension[Ｊ]. Am Surg,2001； 67（5）∶451.
12.	Kopelman T, Harris C, Miller R,et al. Abdominal compartment syndrome in patients with isolated extraperitoneal injuries[Ｊ]. J Trauma,2000； 49（4）∶744.
13.	Loi P, de Backer D, Vincent JL. Abdominal compartment syndrome[Ｊ]. Acta Chir Belg,2001； 101（2）∶59.
14.	Doty JM, Saggi BH, Blocher CR, et al. Effects of increased renal parenchymal pressure on renal function[Ｊ]. J Trauma,2000； 48（5）∶874.
15.	Doty JM, Saggi BH, Sugerman HJ, et al. Effect of increased renal venous pressure on renal function[Ｊ]. J Trauma, 1999； 47（6）∶1000.
16.	Citerio G, Vascotto E, Villa F, et al. Induced abdominal compartment syndrome increases intracranial pressure in neurotrauma patients: a prospective study[Ｊ]. Crit Care Med,2001； 29（7）∶1466.
17.	Moulton RJ. Abdominal compartment syndrome in the head injured patient[Ｊ]. Crit Care Med,2001； 29（7）∶1487.
18.	Pottecher T, Segura P, Launoy A. Abdominal compartment syndrome[Ｊ]. Ann Chir,2001； 126（3）∶192.
19.	Chen RJ, Fang JF, Chen MF. Intraabdominal pressure monitoring as a guideline in the nonoperative management of blunt hepatic trauma[Ｊ]. J Trauma,2001； 51（1）∶44.
20.	Hut’an M, Salapa M, Vandriakova R, et al. Rupture of the laparotomy incision and its suture using Ventrofilm[Ｊ]. Rozhl Chir,2001； 80（3）∶124.
21.	Cohen M, Morales R Jr, Fildes J, et al. Staged reconstruction after gunshot wounds to the abdomen [Ｊ]. Plast Reconstr Surg,2001； 108（1）∶83.
22.	Fenn CH, Butler PE. Abdominoplasty woundhealing complications: assisted closure using foam suction dressing [Ｊ]. Br J Plast Surg, 2001； 54（4）∶348.
23.	Maxwell RA, Fabian TC, Croce MA, et al. Secondary abdominal compartment syndrome: an underappreciated manifestation of severe hemorrhagic shock [Ｊ]. J Trauma, 1999； 47（6）∶995.

1. Grubben AC, van Baardwijk AA，Broering DC，et al. Pathophysiology and clinical significance of the abdominal compartment syndrome[Ｊ]. Zentralbl Chir,2001； 126（8）∶605.
2. Tons C,Schachtrupp A,Rau M,et al.Abdominal compartment syndrome: prevention and treatment[Ｊ]. Chirurg,2000； 71（8）∶918.
3. Sanchez NC, Tenofsky PL, Dort JM, et al. What is normal intraabdominal pressure? [Ｊ]. Am Surg,2001； 67（3）∶243.
4. Kirkpatrick AW, Brenneman FD, Mclean RF, et al. Is clinical examination an accurate indicator of raised intraabdominal pressure? [Ｊ]. Can J Surg,2000； 43（3）∶207.
5. Varela JE, Cohn SM, Giannotti GD, et al. Nearinfrared spectroscopy reflects changes in mesenteric and systemic perfusion during abdominal compartment syndrome[Ｊ]. Surgery, 2001； 129（3）∶363.
6. Joynt GM, Ramsay SJ, Buckley TA. Intraabdominal hypertensionmplications for the intensive care physician[Ｊ]. Ann Acad Med Singapore,2001； 30（3）∶310.
7. Offner PJ, de Souza AL, Moore EE, et al. Avoidance of abdominal compartment syndrome in damagecontrol laparotomy after trauma[Ｊ]. Arch Surg,2001； 136（6）∶676.
8. Ertel W, Oberholzer A, Platz A, et al. Incidence and clinical pattern of the abdominal compartment syndrome after “damagecontrol” laparotomy in 311 patients with severe abdominal and/or pelvic trauma[Ｊ]. Crit Care Med, 2000； 28（6）∶1747.
9. Sieh KM, Chu KM, Wong J. Intraabdominal hypertension and abdominal compartment syndrome[Ｊ]. Langenbecks Arch Surg,2001； 386（1）∶53.
10. Berger P, Nijsten MW, Paling JC, et al. The abdominal compartment syndrome: a complication with many faces[Ｊ]. Neth J Med,2001； 58（5）∶197.
11. Blevins DV, Khanduja KS. Abdominal compartment syndrome with massive lowerextremity edema caused by colonic obstruction and distension[Ｊ]. Am Surg,2001； 67（5）∶451.
12. Kopelman T, Harris C, Miller R,et al. Abdominal compartment syndrome in patients with isolated extraperitoneal injuries[Ｊ]. J Trauma,2000； 49（4）∶744.
13. Loi P, de Backer D, Vincent JL. Abdominal compartment syndrome[Ｊ]. Acta Chir Belg,2001； 101（2）∶59.
14. Doty JM, Saggi BH, Blocher CR, et al. Effects of increased renal parenchymal pressure on renal function[Ｊ]. J Trauma,2000； 48（5）∶874.
15. Doty JM, Saggi BH, Sugerman HJ, et al. Effect of increased renal venous pressure on renal function[Ｊ]. J Trauma, 1999； 47（6）∶1000.
16. Citerio G, Vascotto E, Villa F, et al. Induced abdominal compartment syndrome increases intracranial pressure in neurotrauma patients: a prospective study[Ｊ]. Crit Care Med,2001； 29（7）∶1466.
17. Moulton RJ. Abdominal compartment syndrome in the head injured patient[Ｊ]. Crit Care Med,2001； 29（7）∶1487.
18. Pottecher T, Segura P, Launoy A. Abdominal compartment syndrome[Ｊ]. Ann Chir,2001； 126（3）∶192.
19. Chen RJ, Fang JF, Chen MF. Intraabdominal pressure monitoring as a guideline in the nonoperative management of blunt hepatic trauma[Ｊ]. J Trauma,2001； 51（1）∶44.
20. Hut’an M, Salapa M, Vandriakova R, et al. Rupture of the laparotomy incision and its suture using Ventrofilm[Ｊ]. Rozhl Chir,2001； 80（3）∶124.
21. Cohen M, Morales R Jr, Fildes J, et al. Staged reconstruction after gunshot wounds to the abdomen [Ｊ]. Plast Reconstr Surg,2001； 108（1）∶83.
22. Fenn CH, Butler PE. Abdominoplasty woundhealing complications: assisted closure using foam suction dressing [Ｊ]. Br J Plast Surg, 2001； 54（4）∶348.
23. Maxwell RA, Fabian TC, Croce MA, et al. Secondary abdominal compartment syndrome: an underappreciated manifestation of severe hemorrhagic shock [Ｊ]. J Trauma, 1999； 47（6）∶995.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

IntraAbdominal Hypertension and Abdominal Compartment Syndrome

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