16-month-old child with rapidly increasing waistline

This case presentation of a patient with an abdominal tumor shows the importance of monitoring of intra-abdominal pressure (IAP), abdominal perfusion pressure (APP) and its high sensitivity compared to diagnostic imaging. If the IAP increases, the APP generally decreases. In exceptional cases, such as arterial hypertension as observed in the presented patient, the APP stays normal despite the increase of the IAP. This can result in an abdominal compartment syndrome (ACS) if intra-abdominal hypertension develops and ACS leads to organ damage and increases the mortality. The gold standard for IAP measurement is the intravesical measurement method according to Kron. Measurement of the abdominal girth in intra-abdominal processes is unreliable.