Abdominal Compartment Syndrome

A person suffers from abdominal compartment syndrome where some event has resulted in intra-abdominal pressure (IAP). The build-up of pressure is the result of fluid accumulating in the abdominal cavity. When the pressure in the abdominal cavity increases, it results in intra-abdominal hypertension (IAH). This syndrome leads to organ failure. One of the main causes of abdominal compartment syndrome is an external blunt trauma to the abdominal region. Sepsis also has led to the development of the syndrome.

The abdominal cavity is the region that is extends from the thoracic diaphragm to the pelvis. The stomach, small intestine, large intestine, liver, kidneys, pancreas, spleen, gallbladder, aorta, and vena cava all are located in the abdominal cavity. The cavity is bordered by the vertebrae of the spine, the abdominal muscles, and the base of the pelvis.

When a person has abdominal compartment syndrome, there is pressure build-up that leads to hypoperfusion (a decrease in flow of blood) and ischemia (too little blood flow to an organ, usually as the result of a blocked artery) of the intestines and other organs and tissues in the peritoneal cavity. Basically, the organs are being destroyed because of the pressure. This condition leads to the release of cytokines, development of oxygen free radicals, and a decrease in the production of adenosine triphosphate. Once this has happened, there may be a migration of bacteria from the intestines that might lead to multiple organ dysfunction syndrome (MODS). In addition, abdominal compartment syndrome may lead to respiratory, renal, gastrointestinal, and neurological abnormalities. Due to the interwoven systems of the body, abdominal compartment syndrome can lead to severe harm to other organs outside the abdominal cavity.

A patient who presents with signs of abdominal compartment syndrome should be treated with decompressive laparotomy. The treating physician should create or reopen a laparotomy incision and apply an abdominal closure on a temporary basis. What this procedure does is provide a short-term mechanism to provide more space for the organs and other structures of the abdominal cavity in order to avoid organ collapse as a result of the pressure.

When there is the potential for this condition in a patient, it is critical to monitor the patient for the progression of this syndrome, including measuring any build-up in intra-abdominal pressure. Although there are a number of different ways to measure intra-abdominal pressure, monitoring bladder or intravesicular pressure is common because they are basic methodologies that have minimal risks and costs.

The age and health of the patient also impacts how quickly the build-up of pressure leads to severe harm. A child may go into multiple organ failure at a much lower level of pressure than a healthy adult.

Doctors and other medical personnel must take extra care when patients are at risk for abdominal cavity syndrome because pressure may build slowly and the damage can be done before anyone notices if the medical professionals are not vigilant.

A patient who has had a medical condition develop to the point of abdominal compartment syndrome faces multiple organ failure and death. When this terrible outcome could have been prevented but for the negligence of the treating physician or other medical personnel, it is necessary to hold the responsible parties accountable. The caring and experienced Maine medical malpractice attorneys at Peter Thompson & Associates will work with you to get compensation for the harm that you or your loved one suffered. We provide an initial evaluation during a consultation and will provide you with an honest assessment of what you can expect. To get started, call us at 800.804.2004.