# Perioperative Management and Anesthetic Challenges of Abdominal Compartment Syndrome: A Case Report

## TL;DR

This case report describes the challenges of managing a patient with abdominal compartment syndrome during surgery and emphasizes the importance of careful anesthetic planning.

## Contribution

The paper provides a detailed case report highlighting specific anesthetic strategies for managing abdominal compartment syndrome in a high-risk surgical setting.

## Key findings

- Aggressive pre-induction fluid resuscitation and vasopressor preparedness are critical in managing ACS patients.
- Judicious selection of induction agents and vigilant intraoperative monitoring are essential for preventing hemodynamic collapse.
- Anticipatory planning is necessary to address the profound physiologic derangements associated with ACS.

## Abstract

We present the perioperative management of a patient with abdominal compartment syndrome (ACS) secondary to fecal impaction and bowel perforation. This case highlights the complex challenges associated with ACS in the perioperative setting, particularly the high risk of cardiovascular and respiratory instability. Sudden hemodynamic collapse following induction or surgical incision, as well as complications during decompression, underscore the profound physiologic derangements inherent to this pathology and the critical role of anesthetic planning in patients with this presentation. Key anesthetic considerations include aggressive pre-induction fluid resuscitation, vasopressor preparedness, judicious selection of induction agents, and vigilant intraoperative monitoring of hemodynamic and respiratory status. Anticipatory planning is essential to optimize outcomes in these high-risk patients.