Review

Surgical management of abdominal compartment syndrome; indications and techniques

Ari Leppäniemi

• Correspondence: Ari Leppäniemi ari.leppaniemi@hus.fi

Author Affiliations

Department of Surgery, Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, 00029 HUS, Helsinki, Finland

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2009, 17:17 doi:10.1186/1757-7241-17-17

Published: 14 April 2009

Abstract

The indications for surgical decompression of abdominal compartment syndrome (ACS) are not clearly defined, but undoubtedly some patients benefit from it. In patients without recent abdominal incisions, it can be achieved with full-thickness laparostomy (either midline, or transverse subcostal) or through a subcutaneous linea alba fasciotomy. In spite of the improvement in physiological variables and significant decrease in IAP, however, the effects of surgical decompression on organ function and outcome are less clear. Because of the significant morbidity associated with surgical decompression and the management of the ensuing open abdomen, more research is needed to better define the appropriate indications and techniques for surgical intervention.