A 45-year-old male involved in a high-speed motor vehicle collision presents with a tense, distended abdomen, progressive oliguria, and hypotension despite fluid resuscitation. His intra-abdominal pressure is measured at 25 mmHg. Which of the following is the definitive treatment for this condition?
Placement in a reverse Trendelenburg position
Initiation of continuous renal replacement therapy (CRRT)
Decompressive laparotomy is the definitive treatment for abdominal compartment syndrome (ACS), which is characterized by sustained intra-abdominal pressure >20 mmHg and new-onset organ dysfunction. This surgical procedure involves opening the abdomen to relieve pressure, restore organ perfusion, and improve physiological function. While interventions like fluid management and sedation are part of medical management, they are not definitive treatments for established ACS. Continuous renal replacement therapy may be required to manage renal failure, a complication of ACS, but it does not resolve the underlying cause.
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