الفهرس 
Anatomy of the Abdominal Compartments and Spaces.Only 14 pages are availabe for public view
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Abstract
The abdominal compartment syndrome is defined as intra-abdominal hypertension associated with organ dysfunction. Adverse physiology has been demonstrated in pulmonary, cardiovascular, renal, musculoskeletal/integumentary, and central nervous system function. The gut is the organ most sesitive to increase in intraabdominal hypertension and it develops evidence of end-organ damage befor the development of renal,pulmonary,and cardiovasculardysfunction. The kidney is especially vulnerable to increased IAP because of its anatomic position.
Abdominal hypertension decreases venous return, increases systemic vascular resistance and intrathoracic pressure, and therefore reduces cardiac output. It also adversely affects cardiovascular monitoring. In the presence of increased abdominal pressure, atelectasis and pneumonia are likely
to develop and impaired ventilation may lead to respiratory failure.
Also, blood flow to the liver and kidney may be reduced, resulting in functional impairment of both organs. The adverse effects on gastrointestinal function result from impairing lymphatic, venous, and arterial flow. Anastomotic healing may become a problem under these circumstances.
Decreased venous return through the inferior vena cava in obese patients may lead to venous stasis ulcers and hemorrhage. The correlation of increased intracranial pressure and intra abdominal pressure may be a problem for trauma patients with simultaneous injuries to the head and the abdomen.
There are different therapeutic approaches according to the level of IAP:
1. Grade I (10 – 15 cm of H2O) - To maintain normovolumia.
2. Grade II (16 – 25cm of H20)-Hypervolemic resuscitation.
3. Grade III (26 – 35 cm of H2O) -decompression.
4. Grade IV (>35 cm of H2O) -decompression and re exploration.
Identification of patients at risk, early recognition, and appropriately staged and timed intervention is key to effective management of this condition.
When abdominal compartment syndrome occurs and medical treatment fails, decompressive laparotomy is the only option. without which reduced oxygen delivery and end-organ damage can lead to the development of multiple ogan system failure and death
Diagnostic suspicion may be confirmed with objective measurements of intra abdominal pressure to select patients who may benefit from decompression.
Operative decompression is achieved by abdominal fasciotomy and covering the fascial gap with mesh.All meshes help to effectively decompress the abdomen.
Several techniques in the surgical treatment are available to affect temporary closure of the open abdomen. One of the least expensive and rapid is the gas sterilized, plastic, cystoscopy irrigation bag. This bag is commonly available, and its application is straightforward. it is the preferred initial method of temporary closure, particularly in patients who may require multiple reoperative interventions. The abdominal vacuum assisted closure designed to affect not only a temporary closure but also a permanent fascial closure in most patients. The relative cost of these devices is small.