Intra-abdominal pressure: a predictor of severity in acute pancreatitis

Background: Acute pancreatitis is a multisystem disease which has an unpredictable course. The major consequence of severe acute pancreatitis is usually intra-abdominal hypertension. So, abdominal compartment syndrome occurs with serve increase in intra-abdominal pressure (IAP) with organ failure. If conservative measures fail, some early interventional procedures have to be performed to reduce mortality in those patients. Methods: The ethics committee clearance was obtained. The study included 50 patients who were admitted in our institution with acute pancreatitis (diagnosed based on clinical, radiological, biochemical parameters) from December 2022 to August 2023. Intravesical route was used to measure IAP and it was performed by bladder catheterization using a Foley's catheter which was then connected with a three-way stopcock, which further attached with a water manometer and on that same day APACHE scores was calculated, compared and analyzed. Results: IAP was >25 cm H2O in 48% of patients and 28% of patients developed MODS and they did not survive. The mean IAP among the survivors was 13.56 cm H2O and in non-survivors it was 24.94 cm H2O. Correlation studies between IAP & the clinical severity of acute pancreatitis was significant (p<0.05). Conclusions: IAP seems to be a simple, reliable and single mortality predictor and helps to assess organ failure in acute pancreatitis and it also well correlates with other pancreatic prognostic scores. It also serves as a selective prognostic marker in acute pancreatitis and found to have a direct correlation between IAP and clinical severity of acute pancreatitis.