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Abdominal compartment syndrome in adults

Mark Gestring, MD
Section Editors
Hilary Sanfey, MD
Eileen M Bulger, MD, FACS
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


Abdominal compartment syndrome refers to organ dysfunction caused by intraabdominal hypertension. It may be under-recognized because it primarily affects patients who are already quite ill and whose organ dysfunction may be incorrectly ascribed to progression of the primary illness. Since treatment can improve organ dysfunction, it is important that the diagnosis be considered in the appropriate clinical situation. The definition, incidence, risk factors, clinical presentation, diagnosis, management, and prognosis of intraabdominal hypertension and abdominal compartment syndrome are reviewed here.

The management of the open abdomen following abdominal decompression is discussed separately. (See "Management of the open abdomen in adults".)


Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are distinct clinical entities and should not be used interchangeably.

Intraabdominal pressure — Intraabdominal pressure (IAP) is the steady state pressure concealed within the abdominal cavity [1]. For most critically ill patients, an IAP of 5 to 7 mmHg is considered normal. In a prospective cohort study of 77 supine hospitalized patients, the IAP averaged 6.5 mmHg and was directly related to body mass index [2].

The normal range described above is not applicable for all patients. Patients with increased abdominal girth that developed slowly may have higher baseline intraabdominal pressures. As an example, morbidly obese and pregnant individuals can have chronically elevated intraabdominal pressure (as high as 10 to 15 mmHg) without adverse sequelae [1].


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Literature review current through: Sep 2016. | This topic last updated: Apr 22, 2016.
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