Abdominal Compartment Syndrome in Acute Pancreatitis: A Narrative Review

Abdominal compartment syndrome (ACS) represents a severe complication of acute pancreatitis (AP), resulting from an acute and sustained increase in abdominal pressure >20 mmHg, in association with new organ dysfunction. The harmful effect of high intra-abdominal pressure on regional and global perfusion results in significant multiple organ failure and is associated with increased morbidity and mortality. There are several deleterious consequences of elevated intra-abdominal pressure on end-organ function, including respiratory, cardiovascular, gastrointestinal, neurologic, and renal effects. It is estimated that about 15% of patients with severe AP develop intra-abdominal hypertension or ACS, with a mortality rate around 50%. The treatment of abdominal compartment syndrome in acute pancreatitis begins with medical intervention and percutaneous drainage, where possible. Abdominal compartment syndrome unresponsive to conservatory treatment requires immediate surgical decompression, along with vacuum-assisted closure therapy techniques, followed by early abdominal fascia closure.

Automated summary

Abdominal compartment syndrome is a severe complication of acute pancreatitis, characterized by increased intra-abdominal pressure and new organ dysfunction. It leads to multiple organ failure and higher morbidity and mortality rates. Elevated intra-abdominal pressure has detrimental effects on respiratory, cardiovascular, gastrointestinal, neurologic, and renal functions. Around 15% of severe acute pancreatitis patients develop intra-abdominal hypertension or abdominal compartment syndrome, with a mortality rate of approximately 50%. Treatment involves medical intervention, percutaneous drainage, surgical decompression, vacuum-assisted closure therapy, and early abdominal fascia closure.