Intra-abdominal hypertension is a serious condition that can lead to severe problems with your kidneys, lungs, heart, and other internal organs. Surgical and nonsurgical treatments may help prevent severe complications.
Intra-abdominal hypertension is pressure within your abdominal cavity that exceeds 12 millimeters of mercury (mm Hg). Normal intra-abdominal pressure is between 0 and 5 mm Hg.
Intra-abdominal hypertension is a serious condition that can lead to severe problems with your kidneys, heart, lungs, and other internal organs. Though it’s uncommon in healthy adults, intra-abdominal hypertension is estimated to affect about 1 in 4 people who are admitted to a hospital’s intensive care unit (ICU).
If not treated, intra-abdominal hypertension can lead to intra-abdominal compartment syndrome, a potentially life threatening condition that develops when pressure within your abdominal cavity reaches 20 mm Hg.
Intra-abdominal hypertension usually develops after an illness or injury that affects your internal organs, resulting in inflammation and swelling. These changes can then raise the pressure within your abdominal cavity.
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Other common risk factors for intra-abdominal hypertension include:
- abdominal surgery
- ileus (an intestinal problem that affects the removal of waste from your body)
- intra-abdominal infections
- severe burns and other traumatic injuries
In many cases, shortness of breath or difficulty breathing is the first symptom of intra-abdominal hypertension because pressure on the lungs, the diaphragm, and other muscles necessary for breathing are under abnormal pressure.
Other potential symptoms of intra-abdominal hypertension include:
A physical examination and review of symptoms can help healthcare professionals diagnose intra-abdominal hypertension, but to confirm the diagnosis, it’s necessary to measure abdominal pressure.
Healthcare professionals can use various tools to measure abdominal pressure. One of the most common is a pressure transducer. Healthcare professionals will inject a saline solution directly into your bladder with a syringe and then measure the pressure using a transducer attached to a catheter.
They may also use a Foley catheter, which is inserted into the bladder through the urethra, and a pressure-measuring device.
These measurements can usually be taken quickly, though you may need to be sedated to avoid movement or other factors that may affect pressure readings.
The main goal of intra-abdominal hypertension treatment is to relieve pressure within the abdomen. This can sometimes be done without surgery and, if necessary, with catheters that drain excess fluid from the abdomen. Diuretics — medications that help reduce fluid levels in your body — may also help.
In mild cases, it may be helpful to change position to take pressure off parts of the abdomen. If someone in a hospital may be at risk of intra-abdominal hypertension, a nurse or other healthcare team members may need to move the person to relieve abdominal pressure.
Depending on the cause of intra-abdominal hypertension, thoroughly relieving the bowels may reduce some of the pressure and make extra room within the abdomen.
If conservative approaches don’t work, a doctor may perform a laparotomy. This involves making an incision in the abdominal wall to relieve pressure. It may take a few days for pressures to return to normal.
If treated effectively, intra-abdominal hypertension can be a temporary complication, and full recovery is likely. But because intra-abdominal hypertension is often diagnosed in people with other serious medical conditions, it can be difficult to determine a typical prognosis.
A 2020 study suggests that the ICU mortality rate for people with intra-abdominal hypertension is 4.8%, while the mortality rate for people with normal intra-abdominal pressure is about 1.2%. The research also mentions that ICU stays tend to be longer for people with intra-abdominal hypertension than for those with normal intra-abdominal pressure.
If not treated, intra-abdominal hypertension can progress to abdominal compartment syndrome, which is a medical emergency. It happens when bleeding or swelling in your abdomen creates dangerously high pressure. This pressure can cause multiple organ failure, which can lead to
Because intra-abdominal hypertension is often a complication of abdominal surgery, acute illness, or other trauma, it cannot always be prevented.
By trying to keep your BMI in a healthy range, you may be able to lower your risk of intra-abdominal hypertension.
A diagnosis of intra-abdominal hypertension means that the pressure on your internal organs, muscles, and tissue within the abdomen is unusually high. Intra-abdominal hypertension is more common in people who are in a hospital ICU than in the general public.
It may be a temporary side effect of surgery or illness, but it is also a risk factor for a potentially fatal condition called abdominal compartment syndrome.
Intra-abdominal hypertension can often be treated with catheters that drain excess fluid from the abdomen, with diuretics, or by changing position in a hospital bed. If nonsurgical approaches don’t bring the pressure down, surgery is often an option.