A 50-year-old woman with 55 percent TBSA burns develops a tense distended abdomen, falling urine output and rising peak airway pressures on day three of admission. To confirm the suspected diagnosis, which measurement should be performed?

• A Inferior vena caval diameter on ultrasound
• B Contrast-enhanced CT of the abdomen
• C Serum lactate and base deficit
• D Intravesical (transurethral bladder) pressure measurement ✓

Explanation

Abdominal compartment syndrome is defined by intra-abdominal pressure above 20 mmHg accompanied by new organ dysfunction such as oliguria, raised airway pressures or gut ischaemia, and it is common after major burns from massive resuscitation and visceral oedema. The standard bedside measurement is intravesical pressure via the Foley catheter, since the bladder acts as a reliable transducer of intra-abdominal pressure. Confirmation mandates decompressive laparotomy. Lactate reflects shock generally, CT cannot measure pressure, and inferior vena caval indices are unreliable in this context.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.