Abdominal compartment syndrome in children: the dilemma of treatment.

The Abdominal Compartment Syndrome (ACS) is a clinical entity, which can be defined as the adverse physiologic consequences that occur as a result of a severe increase in intra-abdominal pressure (IAP), and is characterized by cardiovascular, pulmonary, renal, splanchnic, and intra-cranial disturbances regardless of the cause. The level of IAP at which ACS occurs is not known in children, therefore we suggest that the clinical signs of tensely distended abdomen, inability to palpate the femoral pulses, cyanosis of the lower extremities, progressive oliguria and hypoxia due to increasing airway pressures are sufficient to justify abdominal decompression. We report three cases of ACS and review the management of this condition.