Abdominal compartment syndrome is a medical emergency that can occur in critically ill people, such as those in the intensive care unit. Bleeding or swelling in your belly (abdomen) causes dangerous pressure, which leads to organ malfunction. Abdominal compartment syndrome is life-threatening. Early diagnosis and treatment are essential.
Abdominal compartment syndrome (ACS) is a medical emergency that can occur in critically ill people. It happens when swelling and pressure in your belly (abdomen) reach dangerous levels.
Normal intra-abdominal pressure ranges between 0 and 5 millimeters of mercury (mmHg). In critically ill people, the range is between 5 and 7 mmHg. High intra-abdominal pressure may be defined as:
Abdominal compartment syndrome can prevent your organs and muscles from getting enough blood and oxygen. This can lead to multi-organ failure and death, so it must be recognized and treated quickly.
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Abdominal compartment syndrome is rare. It’s most often limited to people in critical condition in the hospital, usually the intensive care unit.
Abdominal compartment syndrome (ACS) occurs when bleeding or swelling causes pressure in your abdomen. Conditions that may cause such bleeding or pressure include:
The signs of abdominal compartment syndrome often appear late, after the syndrome has already caused damage. Healthcare providers must closely monitor people who are at risk for developing abdominal compartment syndrome.
Signs and symptoms may include:
People with abdominal compartment syndrome (ACS) may have:
But the only way to confirm the diagnosis of ACS is to measure intra-abdominal pressure. Your healthcare provider will diagnose ACS if the pressure is higher than 20 mmHg and there’s evidence of organ failure.
The current method for measuring intra-abdominal pressure is to measure bladder pressure. Your healthcare provider will:
This test will be repeated so your healthcare team can tell if the condition is getting worse or better.
Your healthcare provider may also order certain tests to determine whether your organs are malfunctioning. These test may include:
The most effective abdominal compartment syndrome treatment is surgical decompression of your abdomen. Your surgeon will perform a procedure called decompressive laparotomy. They'll make a cut (incision) through your skin and abdominal wall to open the area and release pressure.
Intra-abdominal pressure decreases in the hours after surgery. But it may take several days for the pressure to reach a near-normal level. The incision may not be fully closed until this happens. Some people may require repeat abdominal decompression surgery.
Intra-abdominal hypertension (IAH) may be managed without surgery. Nonsurgical treatments may keep IAH from progressing to abdominal compartment syndrome. These may include:
If abdominal compartment syndrome isn’t treated, it is fatal. Eventually, rising pressure in your abdomen causes more and more organs to shut down. The outlook is also poor if diagnosis and treatment are delayed.
But with early diagnosis and treatment, you can eventually recover from abdominal compartment syndrome.
Recovery from the original health problem can take weeks or months longer than ACS. You may need:
A note from Cleveland Clinic
Abdominal compartment syndrome is a medical emergency that can occur in people with critical illness. It happens when swelling and pressure in your abdomen reach dangerous levels. Early diagnosis and treatment are essential to prevent severe complications and death.
Last reviewed by a Cleveland Clinic medical professional on 05/24/2022.
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