Abdominal compartment syndrome.

Compartment syndrome is a pathophysiological term, comprising a variety of tissues and organ alterations, due to a higher than normal pressure in an anatomically detached space (compartment). In the human body, areas denoted as compartments include the orbital globe, the sub and epidural space, the abdomen, pleura, pericardium, and others. Compartment syndrome was described initially in limbs. Abdominal compartment syndrome is defined as an intra-abdominal pressure above 20 mmHg with evidence of organ failure. Abdominal compartment syndrome develops when the intra-abdominal pressure rapidly reaches certain pathological values, within several hours (intra-abdominal hypertension is observed), and lasts for 6 or more hours. The key to recognizing abdominal compartment syndrome is the demonstration of elevated intra-abdominal pressure which is performed most often via the urinary bladder, and it is considered to be the "gold standard." Multiorgan failure includes damage to the cardiac, pulmonary, renal, neurological, gastrointestinal, abdominal wall, and ophthalmic systems. The gut is the most sensitive to intra-abdominal hypertension, and it develops evidence of end-organ damage before alterations are observed in other systems. The surgical decompression of the abdomen remains the treatment of choice of abdominal compartment syndrome; this usually improves the organ changes, and is followed by one of the temporary abdominal closure techniques in order to prevent secondary intra-abdominal hypertension.