American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the most appropriate method for diagnosing abdominal compartment syndrome?

1. Bladder pressure measurement

2. Physical examination

3. Ultrasound

4. CT scan

The correct answer is: Bladder pressure measurement

The most appropriate method for diagnosing abdominal compartment syndrome is bladder pressure measurement. This approach is widely accepted in clinical practice because it allows for a straightforward and non-invasive assessment of intra-abdominal pressure (IAP). Abdominal compartment syndrome occurs when there is increased pressure within the abdominal cavity, which can compromise the function of the organs within the abdomen. Measuring bladder pressure provides a reliable estimate of IAP because the bladder is located in the abdominal cavity, and its pressure correlates well with intra-abdominal pressure. Typically, a bladder pressure greater than 20 mmHg is suggestive of abdominal compartment syndrome and may warrant further intervention. While physical examination can provide important clinical signs related to abdominal compartment syndrome, it is often subjective and may not accurately reflect the internal pressure. Imaging techniques like ultrasound and CT scans can help identify some of the causes or consequences of increased abdominal pressure, such as fluid collections or abdominal distention, but they do not provide a direct measurement of intra-abdominal pressure. Thus, these methods are not suitable for diagnosing the syndrome itself. In summary, bladder pressure measurement stands out as the most effective and reliable method for diagnosing abdominal compartment syndrome due to its direct correlation with intra-abdominal pressure dynamics.