Published online Feb 15, 2016. doi: 10.4291/wjgp.v7.i1.186
Peer-review started: July 4, 2015
First decision: July 29, 2015
Revised: September 8, 2015
Accepted: November 3, 2015
Article in press: November 4, 2015
Published online: February 15, 2016
Core tip: Intra-abdominal hypertension is not merely an epiphenomenon but offers a unique point of specific intervention in acute pancreatitis and there is increasing data to show improved mortality with appropriate management. It is frequent and may be observed in at least 50% patients with severe disease. Moreover it acts as confounder in management related issues of fluid therapy, nutritional support and antibiotic prophylaxis; and understanding its pathophysiology coherently explains many dichotomies which presently lowers internal validity of much available evidence. Incorporating surveillance for intra-abdominal pressure in select subgroup of patients may help better tailor individualized treatment to patients with most severe spectrum of disease. Recommendations by World Society of the Abdominal Compartment Syndrome may be followed by practicing clinician to guide decision making.