Recognition and management of intra-abdominal hypertension and the abdominal compartment syndrome

Intra-abdominal pressure can be elevated by a variety of surgical and medical causes. Abnormally high intra-abdominal pressures can lead to multi-system organ dysfunction due to a combination of direct pressure effects and the release of endo-toxins which can be life threatening.The key to the successful management of the condition relies on a low threshold for making the diagnosis, an ability to accurately measure and interpret the intra-abdominal pressure and the prompt management by appropriate techniques that may be surgical, non-surgical or both.Despite an increased interest and recognition of the importance of intra-abdominal pressure measurement amongst modern clinicians, correct knowledge of the consensus definitions and recommendations for management remains poor and this article will describe a practical approach to assessing and managing affected patients with a final description of techniques for reconstructing complex abdominal wall defects.