Evaluation of the Relation between Pelvic Fracture and Abdominal Compartment Syndrome in Trauma Patients Who Refered to Nemazee Hospital in Shiraz

Introduction & Multiple factors can lead to increase in acute abdominal pressure and Abdominal Compartment Syndrome (ACS), such as increase in retroperitoneal volume due to pancreatitis, bleeding and edema due to pelvic fracture. It is observed that sometimes pelvic ring fracture or an open book fracture of pelvic can cause a huge pelvic hematoma in retroperitoneal space that causes abdominal compartment syndrome. Primary ACS problem is often observed during the first 24 hours after sever abdominal and pelvic trauma and surgery. Clinicians, especially nurses, should remember the risk factors for intra abdomen hypertension and should be vigilant to avoid the progression to abdominal compartment syndrome. By measuring the Intra-abdominal pressure through the bladder, we can provide a quick and accurate assessment of abdominal pressure changes and this can be performed by emergency or critical care nurses without a specific medical order or sophisticated invasive monitoring equipment. Regarding this matter that ACS is a very lethal condition. This study’s survey had the intention of finding the relationship between pelvic fracture and abdominal compartment syndrome in trauma patients who refer to Nemazee hospital in Shiraz. This research was a descriptive- analytical study that was performed to survey the relationship between pelvic fracture and abdominal compartment syndrome in patients with severe abdominal trauma and pelvic fracture in Nemazee hospital in 2008. Tools for data collection included check list consisting of demographic information and other data required for this research and also intra abdominal pressure (IAP) measurement instruments. The IAP was measured in patients with abdominal trauma who referred to emergency ward via folley catheter indwelling in bladder and pelvic fracture confirmed with pelvic X-ray. Collected data was analyzed by using SPSS software. Of 100 patients with abdominal trauma referred whose abdominal pressure was measured, 28 patients had abdominal compartment syndrome. According to associated injury with abdominal trauma 19% of all patient (19 persons) and 46.42% of the patient with abdominal compartment syndrome (13 persons) had pelvic fracture. Using of qi-sqare test revealed that the relationship between pelvic fracture and incidence rate of abdominal compartment syndrome was significant (P < 0.001). According to our collected data pelvic fracture due to trauma can one of the important causes of increase intra abdominal pressure and abdominal compartment syndrome. In this lethal condition prevention is better than cure. By serial measuring, the Intra abdominal pressure through the bladder in patients at risk, such as pelvic fracture by trauma, nurses can recognize this condition and decrease incidence of mortality.