What is Abdominal Compartment Syndrome (ACS)?
When a person is badly hurt a lot of swelling can happen to the internal organs. This causes pressure on the organs and blood vessels inside. When this pressure is very high, it can hurt or kill the organs in what is called Abdominal Compartment Syndrome or ACS.
How do you diagnose ACS?
Doctors and nurses check the pressure inside your abdomen using a tube hooked to the urine drainage system. The doctors and nurses will be checking to see if there is enough urine coming out of the drainage tube every hour, the pressure inside the urine bladder, and the breathing pressures on the breathing machine. If signs of too much pressure are seen the doctors will take the patient to the operating room.
What is the surgery for ACS?
The surgeons will make a long cut from the bottom of the rib cage to the top of the hip bones in the middle of the stomach area. The surgeons will open the muscles as well to allow the pressure inside to be released. A plastic cover will be sewn over the internal organs and that cover will be sealed and contained with a plastic bandage.
What will I see when I look at my abdomen?
Under the bed sheets you will be able to see the internal organs under the plastic bandage. The plastic covering has a yellow to brown tinge from the medicine to reduce the skin bacteria. Because only the plastic covers are holding the organs in place, it is important to keep the patient very quiet. The nurses will be administering medicine to keep them very quiet and medicine to relax all of their muscles. They will not be able to respond to you if you talk to them.
How long will it be in place?
It will be in place until the patient is stable and the condition for which it is placed has passed. Usually the swelling goes down enough in a few days to allow the doctors to close the skin over the stomach. The doctors may or may not be able to close the muscles over the organs. If this happens, the patient will have to come back in a few weeks to close the muscles.
What if they can't close the abdomen?
If the swelling continues or if infection develops, the stomach cannot be closed for several days or even weeks. The body begins to try to heal over the organs causing them to bind together. This is called a concrete abdomen. This condition causes the organs to become very delicate and develop leaks called fistulas. If these happen the stomach takes a long time to heal. Skin grafts may need to be taken in order to cover the organs temporarily.