<unk>  is defined as an intra-abdominal pressure above 20 mmHg with evidence of organ failure.<unk>  develops when the intra-abdominal pressure rapidly reaches certain pathological values, within several hours (intra-abdominal hypertension is observed), and lasts for 6 or more hours. The key to recognizing<unk>  is the demonstration of elevated intra-abdominal pressure which is performed most often via the urinary bladder, and it is considered to be the "gold standard". Multiorgan failure includes damage to the cardiac, pulmonary, renal, neurological, gastrointestinal,<unk>  wall, and ophthalmic systems. The gut is the most sensitive to intra-abdominal hypertension, and it develops evidence of end-organ damage before alterations are observed in other systems. In a recent systematic review, Holodinsky et al. described 25 risk factors associated with IAH (intra-abdominal hypertension) and 16 with<unk> <unk> . These can be roughly categorized in three categories, which may be more helpful at the bedside to identify patients at risk (Table 1). Especially noteworthy is the potential role of fluid resuscitation in the development of IAH and<unk> . Recognizing the pivotal role of fluid resuscitation in the pathogenesis of IAH and<unk>  supplies the clinician with a target for preventive measures. Large volume resuscitation with crystalloids should be avoided in patients with or at risk of<unk> . +Table 1 When to suspect intra-abdominal hypertension and<unk><unk>  catastrophes Severe organ dysfunction Fluid balance Trauma, peritonitis, acute pancreatitis, ruptured<unk>  aortic aneurysm Often post-surgery Metabolic respiratory renal hemodynamic >3000–4000 mL in 24 h window
Abdominal compartment syndrome
Postcholecystectomy syndrome
PELVIS syndrome
Tertiary peritonitis
Acute abdomen
Spontaneous bacterial peritonitis
Proteus syndrome
Superior mesenteric artery syndrome