Intra-abdominal hypertension and pancreatic destruction in patients with acute necrotizing pancreatitis

Aim: To determine the relationship between intra-abdominal hypertension and the volume of pancreatogenic necrosis in patients with acute necrotizing pancreatitis.

Materials and Methods: A prospective single-center study of 32 adults with acute necrotizing pancreatitis (ANP). A correlation was made between the maximum intra-abdominal pressure (IAP) in the early phase of the disease and the area of pancreatic necrosis and extrapancreatic necrosis (EPN) according to CT data. A one-factor linear regression model was built, based on the linear dependence of the volume of EPN on the maximum value of IAP.

Results: A positive correlation between the IAP level and the volume of EPN was revealed, ρ = 0.547 (p=0.0012). No linear correlation between the level of IAP and the degree of necrosis of the pancreas (p=0.368). The volume of EPN was related to the indicator of IAP(p<0.001). When the IAP level increases for each mm Hg., the volume of EPN increased, on average by 146.29 37.74 ml (p<0.001).

Conclusions: The increase in IAP in the early phase of ANP was accompanied by an increase in the volume of EPN, ρ = 0.547 (p=0.0012). In the study it was possible to predict EPN volume by measuring the level of IAP in the early phase of the disease with an 15.02 ml error. An increased IAP can be considered one of the markers of an increase in the volume of EPN in patients with ANP.