De Waele et al evaluated patients with severe acute pancreatitis (SAP) for evidence of intra-abdominal hypertension. A high intra-abdominal pressure is associated with multi-organ failure, a high mortality rate, and prolonged stay in the intensive care unit (ICU). The authors are from Ghent University Hospital in Belgium.


Patient selection: severe acute pancreatitis


Intra-abdominal hypertension was defined as an intra-abdominal pressure >= 15 mm Hg. The highest reported pressure was 45 mm Hg.


Risk factors for intra-abdominal hypertension:

(1) APACHE II score >= 14

(2) Ransom score >= 6

(3) necrotizing pancreatitis


A patient with intra-abdominal hypertension was at increased risk for renal, respiratory and cardiovascular failures.


Patients who underwent abdominal decompression had a high mortality rate, but the procedure was only performed on patients with high intra-abdominal pressures.


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