Introduction: It is very important to consider that increased intra-ABDOMINAL pressure above the terminal capillary blood pressure causes progressive tissue hypoperfusion, ischemia of the intestines and kidneys as well as other peritoneal and retroperitoneal structures.Materials and Methods: Eleven patients out of 3415 admitted patients in Alzahra and Issabne Maryam (SA) Hospitals were diagnosed to have ABDOMINAL COMPARTMENT SYNDROME (ACS) between 1999 and 2006. Cases with intra-ABDOMINAL pressure of 26 to 35 CmH20 and clinical signs of ACS, anuria, hypoxia and tachycardia were decompressed. Patients with intraABDOMINAL pressure of 36cm H2O or higher were decompressed urgently.Results: Eleven patients (7 males, 4 females) were studied with the youngest being 18 and the oldest being 86. Mortality rate was 64%. One of the important causes of increased mortality was prolonged ACS duration and ABDOMINAL decompression delay. The most probable causes of ACS were severe ABDOMINAL trauma, sepsis and aggressive resuscitation.Conclusion: High index of suspicion for ACS has an important role in its diagnosis and further life saving.

ABDOMINAL COMPARTMENT SYNDROME is a dangerous clinical situation, usually following ABDOMINAL injuries & operations. It is seldom observed in patients with gynecologic and obstetric problems. ABDOMINAL COMPARTMENT SYNDROME may be consequence ovarian hyperstimulation SYNDROME. A 28-year-old woman presented as a sever ovarian hyperstimulation. The increased IAP indicated that OHSS may be considered a COMPARTMENT SYNDROME. ABDOMINAL COMPARTMENT SYNDROME needs laparotomy or paracentesis for reduction of pressure.

Background: ABDOMINAL COMPARTMENT SYNDROME (ACS) after cesarean section (CS) is a rare event which is associated with an increased risk of morbidity and mortality. This complication may arise as a result of musculoskeletal trauma and fluid accumulation. The present report aimed to introduce a case of ACS after the cesarean section. Case report: We present the case of a 32-year old woman who developed ABDOMINAL COMPARTMENT SYNDROME 4 days after the cesarean section. The patient's symptoms included severe ABDOMINAL distension, fever, decreased haemoglobin level despite normal blood pressure, and decreased urine output. Nasogastric/colonic decompression was not effective. Computed tomography (CT) scan demonstrated partial bowel obstruction. After an emergency decompressive laparotomy due to increased intra-ABDOMINAL pressure, the patient was diagnosed with ACS and rescued by supportive conservative treatment. Conclusion: ACS is a rare complication of CS; nonetheless, delayed diagnosis and intervention can cause irreversible damages. The physicians and midwives should be cautious about post caesarean signs and symptoms, including massive ABDOMINAL distention, pain, fever, difficulty breathing, and decreased urine output. Conservative therapeutic strategy and decompressive laparotomy is the gold standard treatment for this disease.

1. Case presentation An 8-month-old, male child was brought to the emergency department (ED) by his parents with difficulty of breathing. The child developed shortness of breath for one day with cough, but he had no fever. According to the parents, they did not notice the ABDOMINAL distension. The child was born prematurely at 25 weeks of gestation and stayed in the neonatal intensive care unit (NICU) for 2 months. Otherwise, he was healthy with minor repeated chest infections and bronchiolitis. In triage, his vital signs were as follows: heart rate: 180 beats/min,respiratory rate: 35 breaths/min,temperature: 35±,C,oxygen saturation: 70%,and his blood pressure was undetected. The child was immediately transferred to the resuscitation room. The primary survey showed that the patient was comatose with a Glasgow coma scale of 3/15, the pupils were brisk with an unstable airway, and there was bilateral diminished air entry. The oxygen saturation did not improve despite assisted ventilation using an Ambu bag. The central and peripheral pulsation was weak with a delayed capillary refill, and the blood glucose level was 9 mmol/L. The abdomen was hugely distended and rigid with minimal rectal bleeding. The patient was immediately intubated and connected to mechanical ventilation with subsequent rising of his oxygen saturation to 100%. A plain chest X-ray examination followed the patient’, s intubation (Figure 1a). Intravenous access was obtained followed by administration of normal saline (20 ml/kg) with subsequent elevation of the blood pressure (82/50mmHg) and decrease in heart rate (160 beats/minute). Initial arterial blood gases (ABG) analysis after intubation showed pH: 6. 6,PaCO2 >150 mmHg,PaO2: 100 mmHg,HCO3: 10mEq/L,and lactic acid: 9 mg/dL. Therefore, a bolus of sodium bicarbonate was given, intravenously. Ventilator parameters were set at the maximum limits to wash out carbon dioxide. Repeated ABG analysis showed pH: 6. 7,PaCO2: 135 mmHg,PaO2: 150 mmHg,HCO3: 17 mEq/L,and lactic acid: 6. 5 mg/dL. Immediate bedside ABDOMINAL X-ray (Figure 1b and c) and ultrasonography were carried out to rule out intussusception. The child remained critically ill and unstable with fluctuating vital signs. Despite high ventilator parameters and gastric tube suction, the child showed no improvement in the respiratory parameters. The child was then transferred to the operation theatre for decompression laparotomy, which showed small bowel (ileum) ischemia. After surgical decompression, the respiratory parameters improved, and the ventilator parameters were set back to normal settings for the patient’, s age and weight. Unfortunately, the child remained critically ill. Then, he developed sepsis and multiple systems organ failure and died after 2 days. 2. Learning points Patients with ABDOMINAL COMPARTMENT SYNDROME (ACS) usually present with ABDOMINAL distension. Respiratory distress, tachycardia, and hypotension are also common findings (1). The presence of all these findings in our patient raised the level of suspicion of ACS diagnosis. Imaging can be a useful aid in ACS diagnosis. On chest X-ray, the presence of unilateral diaphragmatic elevation, pleural effusions, or lobar collapse may suggest the diagnosis of ACS. ABDOMINAL X-ray can confirm the diagnosis of intestinal obstruction (2). ABDOMINAL pressure can bemeasured in several ways. Despite the accuracy provided by direct measurement using intraperitoneal catheters, its use is limited because it is invasive and may be accompanied by traumatic intestinal injury. Indirect measuring via nasogastric, intravesical, or intracolonic pressure transducers is an alternative diagnostic tool. Intravesical pressure monitoring via Foley catheter is the most commonly used method in adults and children (3). ABDOMINAL perfusion pressure is the mean arterial pressure minus the intra-ABDOMINAL pressure (IAP). It was studied as a resuscitative endpoint in ACS, and it was superior to ABG and hourly urinary output (4). The ideal treatment plan should include stabilizing the patient, treating the primary disease, and management of the ACS (5). Well-timed midline laparotomy is the most efficient method of reducing IAP if other treatment modalities are unsuccessful (6). Despite its high mortality rates, ACS is still an underdiagnosed condition, especially among pediatrics. Delay in diagnosis and management has detrimental effects on patients. . .

Treatment of snakebite complications is challenging, as it is difficult to distinguish what kind of antivenins should be used. Kidney failure as a result of rhabdomyolysis or hemolysis may happen due to accumulated fluids that increase the pressure in the abdomen. This case report describes acute kidney failure probably due to intra-ABDOMINAL hypertension following an unknown bite.

Necrotizing fasciitis (NF) is rare in infants, and ABDOMINAL COMPARTMENT SYNDROME (ACS) resulting from NF in an infant has not previously been reported. Proper management is challenging, including the optimal time for treatment. The authors report an infant with Pseudomonas aeruginosa and Staphylococcus epidermidis-mediated NF complicated with ACS and its successful management with combined application of negative pressure wound therapy (NPWT) and split-thickness skin grafts (STSG).

Background: ABDOMINAL COMPARTMENT SYNDROME can have devastating effects on ABDOMINAL visceral organs which eventually can progress to multi-organ dysfunction and death. Various medical and surgical conditions are known to progress to this complication. ABDOMINAL COMPARTMENT SYNDROME is now increasingly recognised as a complication of sepsis and Dengue shock SYNDROME. Life saving measures include reduction of intra-ABDOMINAL pressure and adequate support of dysfunctional organs. Case report: We report the case of a 3-month-old infant with ABDOMINAL COMPARTMENT SYNDROME due to severe dengue illness with multi organ failure with massive ascites. She had a dramatic recovery following ABDOMINAL decompression by therapeutic drainage of 300 ml of ascitic fluid. Conclusion: The spectrum of ABDOMINAL COMPARTMENT SYNDROME features may easily be thought to be part of capillary leak SYNDROME and the diagnosis of ACS could have been missed. Early recognition and aggressive treatment have been shown to significantly improve the outcome.