Pathophysiologie und Bedeutung des abdominellen Kompartmentsyndroms

Pathophysiology and clinical significance of the abdominal compartment syndrome

Summary

Different causes, for example posttraumatic and postoperative complications, can lead to an elevated intra-abdominal pressure. Increased intraabdominal pressure effects cardiovascular, pulmonary and renal systems. The abdominal compartment syndrome can be defined as organ failure caused by an increased intra-abdominal pressure. Clinically the syndrome is characterised by a tensely distended abdomen, oliguria or anuria and/or inadequate ventilation. Early decompression by simple laparotomy and delayed closure is the treatment of choice. If untreated the abdominal compartment syndrome is lethal. Even treated it has a high morbidity and mortality as shown in our series where 2 out of 7 patients with this syndrome died despite surgical decompression.

Zusammenfassung

Posttraumatische und postoperative Komplikationen können Ursache eines pathologisch erhöhten intraabdominellen Druckes sein. Dieser führt zu kardiovaskulären, pulmonalen und renalen Störungen. Entsteht aufgrund des erhöhten intraabdominellen Druckes ein Organversagen, wird von einem abdominellen Kompartmentsyndrom gesprochen. Die häufigsten klinische Zeichen dieses Syndromes sind ein geblähtes Abdomen, Oligurie bis Anurie und die Ateminsuffizienz. Ohne Behandlung verläuft dieses Syndrom meistens letal. Auch bei rechtzeitiger Behandlung sind Morbidität und Letalität hoch. Wir berichten über 7 Patienten mit einem abdominellen Kompartmentsyndrom, die in unserer Klinik diagnostiziert und therapiert wurden. Trotz adäquater chirurgischer Dekompression verstarben 2 der 7 behandelten Patienten. Nur die frühzeitige Erkennung und Behandlung in Form einer chirurgischen Dekompression kann den ansonsten letalen Verlauf verhindern.

Key words

Abdominal compartment syndrome - increased abdominal pressure - postoperative and posttraumatic complications - bladder pressure

Schlüsselwörter

Abdominelles Kompartmentsyndrom - erhöhter intraabdomineller Druck - postoperative und posttraumatische Komplikationen - Harnblasendruck

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