Fig 1. The role of the bowel in relation to intra-abdominal hypertension and abdominal compartment syndrome.

Intra-abdominal hypertension (IAH) has multiple perfusion related consequences on all major organs. The decreased abdominal perfusion pressure (APP) leads to reduced splanchnic perfusion and hypoxia that promotes an anaerobic environment with a low gastric intramucosal pH (pHi). The hostile intestinal environment causes the mucosal damage, injury of the enterocytes, the intestinal barrier dysfunction and the release of inflammatory mediators and cytokines. This results in acute intestinal distress syndrome (AIDS), fuelling the development of abdominal compartment syndrome (ACS) and multiple organ dysfunction syndrome (MODS).