Abdominal Compartment Syndrome (ACS) is a poorly understood, but recognizable, condition that appears in the seriously to critically ill patient. It is currently defined as the presence of decreased function in multiple organ systems that occurs in the presence of an increase in the pressure inside the abdominal cavity, a condition known as intra-abdominal hypertension. Although decreased function of the heart, kidneys, and lungs do occur frequently in the Intensive Care Units, when failure of these systems occur in the presence of an increased pressure in the abdominal cavity it is a sign that reducing this abnormal pressure may result in an improvement in the function of the other organs and may actually be lifesaving.
ACS is most frequently seen in patients who have sustained major traumas such as pelvic fractures, burns, and crushing-type abdominal injuries. Other conditions associated with ACS include tumors that cause a buildup of fluid in the abdominal cavity, pancreatitis (inflammation of the pancreas), and surgery involving the abdominal portion of the aorta. ACS is also being recognized as occurring in patients who require ventilator support of respiration as well as in those who have required multiple blood transfusions or large amounts of intravenous fluids over relatively short periods of time.
Thanks to reviews of older medical records and autopsy results, it is now recognized that intra-abdominal hypertension and ACS can be the signal that the failure of multiple organ systems is imminent unless aggressive efforts at reducing abdominal pressure are implemented.
There is an old rule that has been passed down from one generation of surgeons to the next which states that the best treatment for a life-threatening complication is not to let that complication develop. ACS is a condition that is also best treated by not allowing it to develop. This means that attending physician must carefully monitor the at-risk patient’s condition and take an active part in the training of the Intensive Care Unit nursing staff to insure that they too will know what to look for as well as to anticipate what treatments will be ordered should ACS develop.
If ACS does develop, treatment must include techniques that will reduce the pressure inside the abdomen to as close to normal as is possible. In many cases, such as abdominal trauma that has required surgery, extensive burns, or the presence of large amounts of fluid within the abdomen, this may be difficult to achieve. This difficulty makes it all the more important that strict attention be paid to preventing its development.
Although it isn’t possible to predict in advance which patients will develop ACS, the fact that it is encountered more often in patients with certain pre-existing conditions demands that those patients should be closely monitored to detect its development before other systems become affected.
A legal action alleging malpractice due to negligence for failing to prevent ACS or undertake immediate and proper treatment once the condition did develop will require the services of an attorney who has extensive experience in the management of medical malpractice and wrongful death lawsuits if such a lawsuit is to be successful.
Bringing a successful lawsuit in a case of ACS will require an extensive review of the victim’s prior medical history as well as the event which lead to his or her final hospitalization as by physicians who are recognized by their peers as experts in the diagnosis and treatment of ACS and may well require their testimony as well.
Although lawsuits for wrongful death due to malpractice involving ACS are complex, they are also winnable if they managed by a qualified attorney.