Abdominal Compartment Syndrome in Acute Pancreatitis: A Narrative Review

Abstract

Abdominal compartment syndrome (ACS) represents a severe complication of acute pancreatitis (AP), resulting from an acute and sustained increase in abdominal pressure >20 mmHg, in association with new organ dysfunction. The harmful effect of high intra-abdominal pressure on regional and global perfusion results in significant multiple organ failure and is associated with increased morbidity and mortality. There are several deleterious consequences of elevated intra-abdominal pressure on end-organ function, including respiratory, cardiovascular, gastrointestinal, neurologic, and renal effects. It is estimated that about 15% of patients with severe AP develop intra-abdominal hypertension or ACS, with a mortality rate around 50%. The treatment of abdominal compartment syndrome in acute pancreatitis begins with medical intervention and percutaneous drainage, where possible. Abdominal compartment syndrome unresponsive to conservatory treatment requires immediate surgical decompression, along with vacuum-assisted closure therapy techniques, followed by early abdominal fascia closure.

Peritoneal Dialysis Complicated by Severe Acute Pancreatitis: A Case Report

“…ACS is a severe complication of SAP. [11,12] It is defined as a sustained intra-abdominal pressure ≥ 20 mmHg (with or without an abdominal perfusion pressure < 60 mmHg) accompanied by new organ dysfunction or failure. The clinical manifestations of ACS encompass various symptoms such as abdominal distension, the presence of significant amounts of free fluid in the abdominal cavity, intestinal cavity, and retroperitoneal cavity, and severe edema affecting the abdominal wall, peritoneum, and intestinal wall.…”

“…ACS is a severe complication of SAP. [11,12] It is defined as a sustained intra-abdominal pressure ≥ 20 mmHg (with or without an abdominal perfusion pressure < 60 mmHg) accompanied by new organ dysfunction or failure. Common imaging findings include: (1) massive ascites and abdominal distension; (2) thickening of the intestinal wall; (3) closure of interorgan spaces in the abdomen; (4) gas in the stomach, small intestine, and colon, dilatation of the intestinal lumen, and extensive swelling and blurring of mesenteric root; (5) feather sign, spring sign, and cogwheel sign of small intestinal mucosa; (6) pancreatic swelling, thickening, and significant exudation; and (7) compression or displacement of the kidneys and stenosis of the renal artery and vein and inferior vena cava.…”

A Custom-Tailored Multichannel Pressure Monitoring System Designed for Experimental Surgical Model of Abdominal Compartment Syndrome

“…Abdominal compartment syndrome (ACS) is a dangerous and challenging condition in clinical practice [ 1 , 2 , 3 , 4 , 5 ]. According to the definition of the World Society of the Abdominal Compartment Syndrome (WSACS), intra-abdominal hypertension (IAH) is a condition where the pressure in the abdominal cavity is 12 mmHg or above [ 6 ].…”

Az akut pancreatitis kezelésének aktuális kérdései a sebész szemszögéből

“…Ezek az akut hasi katasztrófát okozó szövődmények a hasűri vérzés, az üreges szerv átfúródása és a hashártyagyulladás [1,2,6,11,13,[24][25][26][27][28][29][30]. A hasűri nyomás emelkedésének talaján kialakult hasi kompartment szindróma (abdominal compartment syndrome -ACS) esetén, amennyiben a nem sebészi kezelések eredménytelenek, a műtét abszolút javallt [1,3,4,6,11,24,[31][32][33]. Ilyen esetekben a dekompressziós laparotomia életmentő lehet.…”

“…A nyomásviszonyok rendeződéséig nyitotthas-kezelést kell folytatni, melynek azonban számos szövődménye és hátránya van. Ezeket hivatott a negatívnyomás-terápia enyhíteni és megelőzni, amely ma már a hasüregi kompartment szindróma esetén az első választandó kezelés [3,[32][33][34].…”