Keywords: multi-organ dysfunction, intra-abdominal pressure, abdominal trauma. Address of the authors: 1 Department of surgery Gen.Ur.T.O., University of Palermo, Italy. 2 Department of Anestesiology, University of Palermo, Italy. 3 Department of Surgery and Emer- gency, University of Palermo, Italy. 4 Department of Medicine and Car- diology, University of Palermo, Italy. 5 Orthopaedic and Traumatology Unit, Ospedale Santa Maria del Prato, Feltre (BL), Italy. Send correspondence: Dr. Ambra Di Benedetto amdibene@jumpy.it Received: June 18th, 2009 Revised: July 9th, 2009 Accepted: July 21, 2009 Language of the Article: English. No conflicts of interest were declared. © CAPSULA EBURNEA, 2009 ISSN: 1970-5492 DOI: 10.3269/1970-5492.2009.4.15 ABDOMINAL COMPARTIMENTAL SYNDROME: A CONCISE CLINICAL REVIEW Ambra Di Benedetto 1 , Andrea Cortegiani 1 , Giuseppe Angelo 2 , Nicola Lo Biundo 3 , Provvidenza Damiani 4 , Antonio Ciulla 2 , Alessandro Geraci 5 , Giovanni Tomasello 1 Introduction The abdominal compartment syndrome (ACS) can be considered as the result of hypoperfusion and ischemia of intra-abdominal viscera and subse- quent multiple organ failure (MOF) caused by raised intra-abdominal pressure (IAP). Various mechanism and systems are interested by this syndrome: the lung, the venous return, the perfu- sion in the abdominal organs, the kidney; it also can be noticed splanchnic ischemia with metabolic acidosis, liver dysfunction. We can divide this syn- drome in three phases with growing gravity, that can modify the therapeutic approach and the pa- tient’s outcome. Clinical remarks The diagnosis of this syndrome is very difficult because it usually occurs in critically ill patients in Intensive Care Units (ICU) with other causes of circulatory or respiratory failure (1). In 2004, a consensus conference was convened by the World Society of the Abdominal Compartment Syndrome (WSACS, see at http://www.wsacs.org ) consisting of European, Australasian, and North American surgical, trauma, and medical critical care special- ists. Recognizing the lack of accepted definitions, and the resulting confusion and difficulty in com- paring studies published in this area, the WSACS tasked these specialists to create evidence-based definitions for Intra-abdominal Hypertension (IAH) and ACS. After extensively reviewing the existing literature, the authors suggested a conceptual Review Article Abstract The abdominal compartment syndrome (ACS) is considered as the result of hypoperfu- sion and ischemia of intra-abdominal viscera with multiple organ failure due to raised intra-abdominal pressure (IAP). This syndrome is very difficult to identify because it usually occurs in critically ill patients in Intensive Care Units. Normal IAP ranges be- tween 0 and 5 mmHg. When it is mildly increased (10-15 mmHg), cardiac index is maintained or lightly increased due to the abdominal viscera squeezing and venous return increasing. In this phase intravascular gradient volume will probably be correct spontaneously. At 15-25 mmHg, intra-abdominal pressure is moderately increased and the full syndrome may be observed, but can be still corrected with simple interven- tions. At higher pressures (>25mmHg) it must be realized surgical decompression, fluid resuscitation together with vasoconstrictive agents. Current diagnostic proce- dures for intra-abdominal measurement relies on bladder pressure’s evaluation. CAPSULA EBURNEA, 4(15):1-3, 2009 Available on-line at: http://www.capsulaeburnea.org