Abdominal and Orbital Compartment Syndrome

Abdominal compartment syndrome often follows laparotomy. Tissue swelling combined with packing or haematomas may cause rising abdominal pressures, causing cardiovascular, respiratory, renal and cerebral dysfunction.
It is best noticed by a fall in urine output + raised JVP

Increased Risk If:
Diminished Abdominal Wall Compliance
    acute respiratory failure (especially with elevated intrathoracic pressure)
    abdominal surgery with fascial closure
    major trauma/burns
    prone positioning
    head > 30 degrees
    high BMI
    central obesity
Increased Intra-luminal Contents
    gastroparesis
    ileus
    colonic pseudo-obstruction
Increased Abdominal Contents
    haemo/pneumoperitoneum
    ascites
    liver dysfunction

Capillary Leak or Fluid Resuscitation
    acidosis (pH < 7.2)
    hypotension
    hypothermia (T < 33 C)
    massive transfusion (> 10 U in 24 hrs)
    coagulopathy
    massive fluid resuscitation
    pancreatitis
    sepsis
    oliguria
    damage control laparotomy

Orbital Compartment Syndrome

Retrobulbar hemorrhage with acute orbital compartment syndrome is primarily a clinical diagnosis. CT may show a diffuse, increased reticular pattern of the intraconal orbital fat rather than a discrete hematoma.
A teardrop or tenting sign is ominous - it occurs when the optic nerve is at maximum stretch and distorts the back of the globe into a teardrop shape.

The main steps in emergency canthotomy/ cantholysis are:
        use local anesthetic but warn the patient that they may feel pain
        Perform the canthotomy:
            place the scissors across the lateral canthus and incise the canthus full thickness
        Perform cantholysis:
            Grasp the lateral lower eyelid with toothed forceps
            Pull the lower eyelid anteriorly
            Point the scissors toward the patient’s nose, place the blades either side of the lateral canthal tendon, and cut
http://ccforum.com/content/4/1/23
http://lifeinthefastlane.com/ophthalmology-befuddler-033-2/