The pelvic compartment syndrome (PCS) is rare. However, it is important to identify it as early as possible so that therapy can be started before irreversible damage occurs.


The usual cause is an expanding hematoma in the pelvis, often following pelvic trauma.


Features of the pelvic compartment syndrome:

(1) compression of the iliac veins with edema of the lower extremities and genitalia

(2) compression of one or both ureters with proximal dilatation

(3) elevated pressure in the urinary bladder

(4) presence of blood or fluid in the Douglas pouch on rectal exam

(5) exclusion of an explanation outside of the true pelvis


Barriers to detection:

(1) severe abdominal compartment syndrome

(2) damage control surgery

(3) other major trauma


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