Role of intra-abdominal pressure monitoring in the management of patients with blunt injury abdomen

Sridhar Punyapu, Mallesh Naredla, Chandrasekhara Reddy Kola, Niharika Adusumilli, Prerana Raju Gudimetla


Background: Blunt injury abdomen is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. The aim was to study the role of intra-abdominal pressure (IAP) monitoring in the management of patients with blunt injury abdomen.

Methods: Hospital based prospective observational study in 77 patients who presented to emergency medicine department with blunt injury abdomen for over a period of 22 months. Age ≥18 years, patients with acute blunt injury abdomen are included in study.

Results: Our study population (77 patients) were a group of patients who presented with blunt injury to abdomen, out of which 66 were male (85.70%), 11 were female (14.30%). Most common age group involved in our study was 20-30 years, mean time of presentation to the hospital was 7.40 hours. SBP, DBP, SpO2 decreased significantly as IAP increases. P. R., R. R. increased significantly as IAP increases. U/O decreased significantly as IAP increases. Sr. Cr, B.U. increased significantly as IAP increases. Surgical abdominal decompression had helped in all operated patients to get statistically significant decrement of IAP during initial post-operative hours. 12 patients required ventilator support in surgically intervened group. Mean duration of hospital stay was 8.025 days. Mortality rate in our study was 3.9%.

Conclusions: Before development of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS), the potential candidates should be offered surgical decompression at proper time.


Intra-abdominal pressure, Intra-abdominal hypertension, Abdominal compartment syndrome

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Vlies CHVD, Olthof DC, Gaakeer M, Ponsen KJ, Delden OMV, Goslings JC. Changing patterns in diagnostic strategies and the treatment of blunt injury to solid abdominal organs. Int J Emerg Med. 2011;4:47.

Mehta N, Babu S, Venugopal K. An experience with blunt abdominal trauma: evaluation, management and outcome. Clin Pract. 2014;4(2):599.

Karamercan A, Yilmaz TU, Karamercan MA, Aytac B. Blunt abdominal trauma: evaluation of diagnostic options and surgical outcomes. Ulus Travma Acil Cerrahi Derg. 2008;14(3):205-10.

Bhoir LN, Hukeri A. Role of intra vesicle pressure monitoring in patients of blunt traumatic acute abdomen: a study of 52 cases. Ann Surg Int. 2016;2(4):1-7.

Bains L, Lal P, Mishra A, Gupta A, Gautam KK, Kaur D. Abdominal Compartment Syndrome: A Comprehensive Pathophysiological Review. MAMC J Med Sci 2019;5:47-56.

Wilden GMVD, Velmahos GC, Emhoff T, Brancato S, Adams C, Georgakis G, et al. Successful nonoperative management of the most severe blunt liver injuries: A multicenter study of the research consortium of New England centers for trauma. Arch Surg. 2012;147(5):423-8.

Tiwari AR, Pandya JS. Study of the occurrence of intra-abdominal hypertension and abdominal compartment syndrome in patients of blunt abdominal trauma and its correlation with the clinical outcome in the above patients. World J Emerg Surg. 2016;9:5-11.

Amuthan J, Vijay A, Pradeep C, Anandan H. A clinical study of blunt injury abdomen in a tertiary care hospital. Int J Sci Study. 2017;5(1):108-12.

Khan S, Verma AK, Ahmad SM, Ahmad R. Analyzing intra-abdominal pressures and outcomes in patients undergoing emergency laparotomy. J Emerg Trauma Shock. 2010;3(4):318-25.

Ravishankar N, Hunter J. Measurement of intra-abdominal pressure in intensive care units in the United Kingdom: a national postal questionnaire study. Br J Anaesth. 2005;94(6):763-6.