Perioperative Management and Anesthetic Challenges of Abdominal Compartment Syndrome: A Case Report.

We present the perioperative management of a patient with abdominal compartment syndrome (ACS) secondary to fecal impaction and bowel perforation. This case highlights the complex challenges associated with ACS in the perioperative setting, particularly the high risk of cardiovascular and respiratory instability. Sudden hemodynamic collapse following induction or surgical incision, as well as complications during decompression, underscore the profound physiologic derangements inherent to this pathology and the critical role of anesthetic planning in patients with this presentation. Key anesthetic considerations include aggressive pre-induction fluid resuscitation, vasopressor preparedness, judicious selection of induction agents, and vigilant intraoperative monitoring of hemodynamic and respiratory status. Anticipatory planning is essential to optimize outcomes in these high-risk patients.