Abdominal compartment syndrome in the pediatric patient with blunt trauma.

Abdominal compartment syndrome in the trauma patient is usually associated as a post surgical complication or as a consequence of full thickness burns to the trunk and abdomen. It is not widely recognized in patients who have received massive fluid resuscitation in the absence of abdominal pathology. This paper will present a case study of a pediatric patient who was the victim of a motor vehicle collision. This 4-year-old boy was hemodynamically unstable initially and received massive fluid resuscitation in the emergency department and pediatric intensive care unit. An emergency laparotomy revealed massive bowel edema but no significant abdominal injury or bleeding. The patient underwent abdominal decompression and returned to the pediatric intensive care unit with an open abdomen covered with a temporary dressing. Differences in pediatric anatomy and physiology which can predispose children to this condition will be explained. In addition pathophysiologic responses to trauma that contribute to abdominal compartment syndrome and nursing care of this condition will be explored.