Abdominal Compartment Syndrome

Purpose of review Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) can cause progressive multisystem organ dysfunction in critically ill patients. This review summarizes the epidemiology, pathophysiology, diagnosis, and management of IAH and ACS, emphasizing physiologic mechanisms, early recognition, and strategies to prevent progression to ACS. Recent findings IAH remains common in critically ill populations, although the incidence of ACS varies substantially according to patient population and surveillance practices. Contemporary evidence emphasizes recognizing accumulating risk factors, standardizing intra-abdominal pressure monitoring in at-risk patients, and early correction of reversible contributors to elevated pressure. Current management still utilizes decompressive laparotomy, but advances in temporary abdominal closure technology and early enteral nutrition have supported earlier definitive fascial closure, which has improved morbidity and mortality. Summary ACS represents the severe end of a continuum of pressure-related organ dysfunction. Early recognition and treatment of IAH are essential, while established ACS requires prompt surgical evaluation and decompression when less invasive measures are insufficient.