ECCO Gastrointestinal Disorders Practice Exam

In the context of a patient with liver failure and ascites who presents with a sustained intra-abdominal pressure (IAP) of 26 mmHg, the correct anticipation is preparation for surgery. This elevated IAP suggests a condition known as abdominal compartment syndrome, a serious state that can occur when intra-abdominal pressure rises to a level that impairs organ function.

When IAP is significantly elevated, especially above 20 mmHg, it can lead to decreased blood flow to vital organs, including the kidneys and intestines, and may result in multi-organ failure. Surgical intervention, often in the form of decompression, may be required to reduce the pressure within the abdomen. This could involve procedures such as paracentesis or exploratory laparotomy, depending on the underlying causes of the elevated pressure and the patient's overall condition.

The other options may not adequately address the critical nature of the situation. Increased fluid intake would likely exacerbate ascites and further elevate IAP, while medication adjustments may not sufficiently address the immediate risk associated with a sustained high pressure in the abdomen. Similarly, while increasing mobility is generally beneficial for patients, it would not be appropriate in a case where elevated IAP poses an immediate threat to organ function.