Expeditious Diagnosis and Laparotomy for

Patients with Acute Abdominal Compartment

Syndrome May Improve Survival

Causes of abdominal compartment syndrome (ACS) are varied and can result from both medical

and surgical diseases. Early recognition of ACS and prompt surgical treatment has been shown to

improve mortality. We hypothesize that earlier recognition of ACS and earlier involvement by

surgical specialists may improve mortality. A retrospective review between July 2010 and July 2015

was performed of adult patients who underwent decompressive laparotomy for ACS. Patients

were divided into surgical and medical intensive care units (SICU and MICU) arms. Twenty patients

were included (MICU 5 12; SICU 5 8) without significant difference between the groups.

Median time from admission to suspicion for MICU patients was 60 hours versus 13 hours for

SICU patients (P 5 0.013). Time from suspicion to surgical consult was 60 minutes versus 0 minutes,

respectively (P 5 0.003), however, time from surgical consult to intervention was not different.

Mortality rate in the MICU was 83 per cent versus 12.5 per cent in the SICU (P 5 0.005).

Patients in the SICU who developed ACS were more quickly diagnosed than those in the MICU.

These patients had a shorter time from suspicion of ACS to surgical consultation and eventual

surgical intervention, and was associated with improved survival. A multidisciplinary approach,

including early surgical consultation, for patients in whom there is a suspicion of ACS may

contribute to improved mortality.

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