ABSTRACT
Postinjury ACS is defined by the presence of intra-abdominal hypertension (IAH) with intra-abdominal pressure (IAP) greater than 23 mm Hg accompanied by organ dysfunction(s) such as cardiac, respiratory and renal.1 ACS is referred to as “secondary” when there are no intraperitoneal injuries. To avoid misclassification, several issues need to be clarified. Patients whose abdominal parenchymal organ injuries are managed nonoperatively should not be categorized as secondary ACS since they have intraperitoneal injuries. Pelvic fracture related retroperitoneal hematomas without intraperitoneal injury are classified as sec ondary ACS. However, retroperitoneal vascular, renal, duodenal, pancreatic etc injuries requir ing laparotomy with and without packing should not be classified secondary ACS group. Bur rows et al reported the first trauma related secondary ACS case in his series of primary ACS cases in 1998.2 The terminology (“secondary ACS”) was attributed to Maxwell et al who de scribed 6 cases and mentioned the potential connection with massive resuscitation.3
