부산대학교 도서관

Acute pancreatitis is a risk factor for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). As ACS is well known to be associated with a high mortality risk, one of the goals of treatment in patients with acute pancreatitis should be to prevent the development of IAH/ACS. There are numerous factors associated with increase of the intra-abdominal pressure in these cases, including inflammation of the pancreas itself, intestinal edema, and ascites. Proper fluid management is an important intervention for preventing IAH/ACS. Surgical decompression should be avoided if possible. The management of IAH/ACS utilizing the step-up approach should be implemented, from noninvasive treatment, including fluid strategies, to invasive treatments. While use of surgical decompression to manage ACS developing as a complication of acute pancreatitis has decreased in recent years, surgical decompression should be performed promptly in cases where it is difficult to control the intra-abdominal pressure. Drawing on the findings of recent studies and our own experience, herein, we discuss fluid strategies for preventing elevation of the intra-abdominal pressure, the step-up approach from noninvasive to invasive treatments, and the pitfalls in the treatment of ACS.