[Acute intra-abdominal hypertension and "abdominal compartment syndrome"].

The acute intra-abdominal hypertension causes profound physiologic abnormalities, both within and outside the abdomen. Just as in compartment syndrome in the extremities, gut mucosal ischemia begins long before clinical signs are evident, explaining the name of "abdominal compartment syndrome" given to the acute, markedly increased intra-abdominal pressure. The abdominal compartment syndrome was initially described in patients with severe abdominal injuries and massive transfusions and crystalloid infusions, caused by the closure of fascia or skin under tension, the use of bulky abdominal packs to control diffuse bleeding, the massive bowel distension and edema, and the continued bleeding into the abdominal cavity.

[Serial repeated laparatomy in severe trauma].

Multivisceral trauma and exanguinating hemorrhage lead to hypothermia, coagulopathy and acidosis. Formal resections and reconstructions in these unstable patient is often result in irreversible physiologic insult. For the patients with life-threatening injuries the staged control and repair of injuries may be a saving surgical strategy.