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Abdominal compartment syndrome: what radiologist needs to know

  • Abdominal Radiology
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Abstract

The intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS) are life-threatening conditions with a significant rate of mortality; therefore, early detection is paramount in their optimal management. IAH is diagnosed when the intra-abdominal pressure (IAP) is more than 12 mmHg. It can occur when the intra-abdominal volume increases (ileus, ascites, trauma, pancreatitis, etc.) and/or the abdominal wall compliance decreases. IAH can cause decreased venous flow, low cardiac output, renal impairment, and decreased respiratory compliance. Consequently, these complications can lead to multiple organ failure and induce the abdominal compartment syndrome (ACS) when IAP rises above 20 mmHg. The diagnosis is usually made with intravesical pressure measurement. However, this measurement was not always possible to obtain; therefore, alternative diagnostic techniques should be considered. In this setting, computed tomography (CT) may play a crucial role, allowing the detection and characterization of pathological conditions that may lead to IAH. This review is focused on the pathogenesis, clinical features, and radiological findings of ACS, because their presence allows radiologists to raise the suspicion of IAH/ACS in critically ill patients, guiding the most appropriate treatment.

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Acknowledgements

Thanks to Ciro Acampora for the teachings.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. The authors have no relevant financial or non-financial interests to disclose.

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  1. Martina Caruso, Chiara Rinaldo and Francesca Iacobellis contributed equally to this work.

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  1. Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131, Naples, Italy

    Martina Caruso, Chiara Rinaldo, Francesca Iacobellis, Giuseppina Dell’Aversano Orabona, Dario Grimaldi, Marco Di Serafino, Maria Laura Schillirò, Francesco Verde, Vittorio Sabatino, Costanza Camillo, Gianluca Ponticiello & Luigia Romano

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All authors contributed to the study conception and design. Material preparation and literature search were performed by Giuseppina Dell’Aversano Orabona, Dario Grimaldi, Marco Di Serafino, Maria Laura Schillirò, Francesco Verde, Vittorio Sabatino, Costanza Camillo, Gianluca Ponticiello. The first draft of the manuscript was written by Martina Caruso, Chiara Rinaldo, Francesca Iacobellis. Supervision was performed by Luigia Romano. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Caruso, M., Rinaldo, C., Iacobellis, F. et al. Abdominal compartment syndrome: what radiologist needs to know. Radiol med 128, 1447–1459 (2023). https://doi.org/10.1007/s11547-023-01724-4

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