The abdominal compartment syndrome - widely unknown in gastroenterology

A sustained increase in intra-abdominal pressure may derange cardiovascular haemodynamics, respiratory and renal functions and finally lead to multi-organ failure. It is primarily seen in surgical intensive care units and is most frequently associated with small and large bowel surgery, vascular surgery, and abdominal trauma. An expert panel has defined elevated intra-abdominal pressure > 20 mmHg in conjunction with newly occurring organ dysfunction as "abdominal compartment syndrome" (ACS). This entity is not well recognised in gastroenterology, although ACS may occur as a complication of endoscopic perforation resulting in tension pneumoperitoneum. With the propagation of laparoscopic procedures it may be appropriate to emphasise the importance of intra-abdominal pressure monitoring in order to avoid this potentially lethal complication.