The abdominal compartment syndrome (ACS) may be defined as the adverse physiologic consequences that occur as a result of an acute increase in intra-abdominal pressure (IAP). Clinically, the organ systems most affected include the cardiovascular, renal, and pulmonary systems. Decreased cardiac output, increased peripheral resistance, oliguria, anuria, increased airway pressure, decreased compliance, and hypoxia may all occur. If untreated, ACS leads to lethal organ failure. In contrast, decompression of the abdominal cavity immediately reverses the above pathophysiologic changes. The most common cause of the syndrome is coagulopathy and postoperative hemorrhage. Although these may occur following any abdominal procedure, they are most often seen in trauma patients.