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Online ISSN 1827-1847
Mayer D. 1, Pfammatter T. 2, Gauer J. M. 1, Wilhelm M. 1, Labler L. 1, Weber D. 3, Genoni M. 1, Lachat M. 1
1 Clinic for Cardiovascular Surgery University Hospital Zurich, Zurich, CH
2 Institute of Diagnostic Radiology University Hospital Zurich, Zurich, CH
3 Trauma Centre, University Hospital Zurich, Zurich, CH
The mortality rate after ruptured abdominal aortic aneurysm (rAAA) has remained nearly constant during the last 50 years, with multiple organ failure (MOF) representing the leading cause of death in those patients surviving operative repair. MOF is generally a consequence of intra-abdominal hypertension (IAH), which occurs when hematoma from aortic rupture and edema from fluid resuscitation reduce abdominal free space. Abdominal compartment syndrome (ACS) is the condition where IAH induces organ dysfunction. ACS without expedient decompression laparotomy has up to 100% mortality. Although the role of ACS in aortic surgery has been pointed out during the last decade, the literature dealing with it is still rather scarce and sometimes confounding. Moreover, most contemporary reports about rAAA still do not describe IAH and/or ACS, which has to be interpreted as an underscoring of that entity. This review describes effective management strategies for reducing the significant morbidity and mortality of IAH/ACS.