Abstract
If acute pancreatitis progresses to a severe state, the resulting intra-abdominal pressure (IAP) can cause severe complications. WSACS has defined a sustained or repeated IAP ≥12mmHg as IAH and a sustained IAP >20mmHg associated with new organ dysfunction/failure as abdominal compartment syndrome (ACS). The incidence of ACS was 4%-6%, the mortality rate was 47.5% with a high incidence of organ failure, and the incidence of complications including sepsis and secondary pancreatic infection was high. Therefore, if CT findings showing fluid collection at multiple sites, massive fluid resuscitation, and renal and/or respiratory dysfunction are obtained, the IAP (trans-bladder technique) should be monitored over time. Medical treatment for IAH/ACS consists of gastrointestinal decompression, intra-abdominal decompression, improved abdominal wall compliance, optimized fluid administration, and optimized systemic/regional perfusion, with the maintenance of IAP ≤15mmHg as the treatment goal. However, surgical decompression, including invasive drainage, should be considered in cases that are refractory to conservative treatment.
