Painful paraplegia caused by spontaneous intraabdominal compartment syndrome: a new differenzial diagnosis?

We report of two patients with spontaneous non-traumatic paraplegia and concurrent severe abdominal pain. Within hours after admission both patients developed multiorgan failure with predominant fulminant hepatic failure. Aortic dissection, Leriche syndrome, spinal cord compression, Budd-Chiari syndrome, portal vein thrombosis and intoxications were excluded. One patient died after 12 hours. The Post-mortem revealed a spontaneous intraabdominal compartment syndrome. The second patient underwent emergency laparotomy and partially recovered. Abdominal compartment syndrome should be considered in all patients with abdominal pain and paraplegia, if aortic dissection has been excluded.