Abdominal hypertension in Meigs' syndrome.

AIMS: Two cases of chronic abdominal hypertension in pseudo-Meigs' syndrome, one sustained by a large ovarian bilateral carcinoma and the other by a giant genital angiomyolipoma, are reported.

METHODS AND RESULTS: Both patients presented to the emergency room for abdominal distention and pain with progressive respiratory dysfunction, hypotension over several days, and early symptoms of renal failure, together suggestive of chronic, intra-abdominal hypertension.

DISCUSSION: Intra-abdominal hypertension and abdominal compartment syndrome are serious conditions which may complicate large tumors and tense ascites, apart from their benign or malignant nature. The chronic development of abdominal hypertension and onset of the abdominal compartment syndrome associated with Meigs' syndrome must be recognized in a timely manner and promptly treated by performing as complete a resection of the pelvic mass as possible; alternatively, in acute abdominal hypertension the monitoring of bladder pressure can evaluate the effectiveness of medical therapy and determine the optimal timing of decompressive laparotomy in case of the abdominal compartment syndrome.