TY - CHAP M1 - Book, Section TI - Acute Abdominal Dysfunction A1 - Ho, Vanessa P. A1 - Barie, Philip S. A2 - Oropello, John M. A2 - Pastores, Stephen M. A2 - Kvetan, Vladimir PY - 1 T2 - Critical Care AB - KEY POINTSCauses of acute abdominal pathology in the intensive care unit (ICU) patient include acute acalculous cholecystitis (AAC), severe acute pancreatitis, feeding intolerance, paralytic ileus and diarrhea, and abdominal compartment syndrome (ACS).An emergent bedside laparotomy may be indicated for patients with a high suspicion for intra-abdominal pathology; however, this is a high-risk procedure, requires substantial resources to be mobilized, and has a risk of mortality.Modern management of pancreatic necrosis and infected necrosis, known as the “step-up” approach, consists of initial medical management with fluid resuscitation and antibiotic administration, followed by percutaneous catheters for drainage of infected fluid.Feeding intolerance in the critically ill patient can be attributable to the patient's critical illness, medications, intra-abdominal pathology, or underlying disease.Treatment and management of ACS consists of serial monitoring of intra-abdominal pressures (IAP); optimization of systemic perfusion and organ function in the presence of intra-abdominal hypertension (IAH); institution of medical procedures to decrease IAP and reduce end-organ dysfunction; and prompt surgical decompression for refractory IAH or ACS. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1136415059 ER -