Signs And Symptoms Of Compartment Syndrome

This dangerous problem is compounded by the fact that clinicians may easily overlook it or mistake it for something else; the differential diagnosis is extensive ( Table 1 ). ACS generally occurs in patients who are already extremely sick, and an intubated patient may not be able to help identify the pain that indicates the condition's onset. Furthermore, many of the signs and symptoms of compartment syndrome may be misinterpreted as being related to the primary condition that brought the patient to the ICU in the first place. The hypotension and organ failure of ACS can easily be mistaken for those of shock, but since the treatments are quite different, the misdiagnosed patient is unlikely to survive to correct the doctors. To help bring focus and attention to and improve survival in patients with ACS, the World Society of the Abdominal Compartment Syndrome (WSACS) was organized in 2004.

Pathophysiology In a healthy person, intra-abdominal pressure (IAP) should average 0 mm Hg or less, but this figure can fluctuate from moment to moment in response to normal activities such as physical activity, respiration, sneezing, and defecation. Obese and pregnant persons can also have higher than normal IAPs, but because these pressures rise gradually, no adverse effects are experienced. The clinical picture is complicated by the fact that IAP is frequently higher in critically ill patients, running 5 to 7 mm Hg.