A WOLF IN WOLFS CLOTHING - THE ABDOMINAL COMPARTMENT SYNDROME

Four patients are described in whom massive abdominal distension after laparotomy led to increased airway and central venous pressure and se verely reduced urine output. All cases were associated with massive fl uid resuscitation and operative findings were a grossly oedematous bow el with free fluid under pressure in the abdomen. These findings are c onsistent with the diagnosis of intra-abdominal compartment syndrome. In 1 case trauma was remote from the abdomen indicating that abdominal surgery or trauma may not be a prerequisite for the development of th e condition. Recognition of the features of the condition is essential as it can only be treated by decompression of the abdominal contents.